Today’s NCLEX-RN® question of the day focuses on a patient diagnosed with chronic hepatitis. What lab results best indicate that the treatment—the medication, lactulose— is working?
The nurse is caring for a client diagnosed with chronic hepatitis who is receiving the medication lactulose. Which of these laboratory results would indicate the medication is achieving the desired therapeutic effect?
A. Decreased serum bilirubin
B. Decreased serum alanine aminotransferase (ALT)
C. Increased serum albumin
D.Decreased serum ammonia
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The correct answer to today’s NCLEX-RN® Question is…
D.Decreased serum ammonia
Rationale: Normally, the liver converts ammonia, which is a by-product of amino acid metabolism, into urea for excretion. So when liver function is impaired, serum ammonia levels rise. To lower ammonia levels, lactulose, which is a synthetic disaccharide, can be administered. As lactulose is degraded by gut bacteria, the pH of the colonic contents decreases. This causes ammonia to be drawn into the colon where it can be and eliminated in the feces, thereby lowering the serum ammonia level.
Major Takeaway
Lactulose works in the colon to lower ammonia levels.
Incorrect answer explanations
A. Decreased serum bilirubin
Rationale: Although the liver plays an important role in bilirubin metabolism and serum bilirubin is increased in clients diagnosed with chronic hepatitis, lactulose is not given to lower serum bilirubin levels.
B. Decreased serum alanine aminotransferase (ALT)
Rationale: Alanine aminotransferase (ALT) is a hepatic enzyme which tends to increase in clients diagnosed with chronic hepatitis, but lactulose is not given for this purpose.
C. Increased serum albumin
Rationale: Because the liver synthesizes albumin liver malfunction can cause albumin levels tend to drop; however, lactulose does not affect albumin levels.
Reference
Burchum, J. R., & Rosenthal, L. D. (2019). Lehne’s pharmacology for nursing care (10th ed.). Elsevier.
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