Lactulose is ordered for a patient with liver disease. What would indicate the medication is exerting a positive therapeutic effect on the patient?

A. Decreased ascites Ascites (accumulation of fluid in the abdominal cavity) is more directly related to portal hypertension and liver cirrhosis. While lactulose may contribute to fluid balance, its primary therapeutic effect in hepatic encephalopathy is the reduction of ammonia levels. B. Decreased ammonia level Lactulose is a medication commonly used in the treatment of hepatic encephalopathy, a condition associated with liver disease. The therapeutic effect of lactulose in this context is to reduce blood ammonia levels. Lactulose works by promoting the excretion of ammonia in the form of ammonium ions in the colon, thereby lowering ammonia concentrations in the blood. C. Decreased jaundice Jaundice is often associated with liver dysfunction, but lactulose is not primarily used to address jaundice. Its primary role in liver disease is in the management of hepatic encephalopathy. D. Decreased blood pressure Blood pressure is not a direct therapeutic target of lactulose in the context of liver disease. Lactulose's primary therapeutic effect is related to reducing ammonia levels and managing hepatic encephalopathy.