NSG 210 Test 3 Study Guide

For ppl not previously vaccinated an im injection of

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Unformatted text preview: if pt is comatose. It has a laxative effect b/c it draws ammonia out of the body via feces. Other laxatives should not be given during lactulose therapy. B/c of it’s laxative effect, pt’s on lactulose should have 2 ­3 BM’s/day. If watery diarrhea is present, this may indicate a medication overdose Pt’s on Lactulose should be monitored for cramps, bloating, hypokalemia, & dehydration. Pt’s serum ammonia level should also be monitored daily Broad spectrum antibiotics such as neomycin sulfate (Mycifradin) & rifaximin (Xifaxan) may be given to reduce levels of ammonia ­forming bacteria in the colon. Xifaxan seems to be the safest for long ­term tx. IV administration of glucose may be administered to minimize protein breakdown Administration of vitamins & electrolytes (esp. K) to correct deficiencies/imbalances Interventions: in addition to nutrition & drug therapy tx listed above Ax neurologic status frequently. Mental status is monitored by keeping a daily record of handwriting & arithmetic performance Ax I&O’s & body weight daily; VS taken q4h Serum ammonia level & electrolyte status is monitored daily Enteral feeding may be provided for pt’s whose PSE state persists Pt’s w/ PSE have a greater risk of respiratory problems b/c of the depressed neurological status. Encourage deep breathing & frequent position changes Patient teaching should include: discontinuation of sedatives, tranquilizers & analgesic meds, maintenance of prescribed diet & how to monitor s/s of PSE. Pt’s should be cautioned that constipation precipitates PSE & should be prevented through the use of lactulose. Use of vegetable protein instead of animal protein may be indicated in pts whose total daily protein tolerance is less than 1g/kg HEPATITIS  ­Incl...
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