A nurse is caring for a patient diagnosed with hepatic encephalopathy. The patient shows signs of confusion and asterixis. Laboratory tests reveal elevated blood ammonia levels. Which nursing intervention involving medication administration is most appropriate to reduce the patient's encephalopathy symptoms?

Choice A rationale Vitamin K is essential for the synthesis of prothrombin and other clotting factors by the liver. While liver disease can impair clotting factor production leading to bleeding risk, administering vitamin K does not directly reduce elevated blood ammonia levels, which are the primary cause of hepatic encephalopathy symptoms like confusion and asterixis. Choice B rationale Lactulose is a nonabsorbable disaccharide that is metabolized by colonic bacteria into lactic acid and other organic acids. This process acidifies the colon, trapping ammonia (NH3) as the non-absorbable ammonium ion (NH4+), which is then excreted in the feces, thus lowering systemic blood ammonia levels and improving encephalopathy symptoms. Choice C rationale Aspirin, a nonsteroidal anti-inflammatory drug (NSAID), works by inhibiting cyclooxygenase enzymes, which reduces prostaglandin synthesis and inflammation. It has no therapeutic role in lowering ammonia levels or treating hepatic encephalopathy. Furthermore, aspirin is generally contraindicated in advanced liver disease due to increased risk of bleeding. Choice D rationale Diuretics, such as loop diuretics or thiazides, increase urine output to reduce fluid volume and manage edema or ascites associated with liver failure. Although cerebral edema can occur in severe acute liver failure, it is not the primary mechanism of confusion in typical chronic hepatic encephalopathy. Diuretics do not directly target or lower systemic ammonia levels. —.