Final Answer:
Confusion is an adverse effect of this medication. Option D is correct.
Step-by-step explanation
Hepatic encephalopathy is a serious complication of liver disease characterized by cognitive and neurological impairment. Lactulose, a common treatment for hepatic encephalopathy, works by promoting the excretion of ammonia in the stool, thus reducing its absorption in the gastrointestinal (GI) tract. Excessive stools in a patient undergoing lactulose treatment can result in electrolyte imbalances, particularly hypokalemia, which can manifest as confusion.
Excessive diarrhea caused by lactulose leads to increased potassium loss in the stool. Potassium (K+) is a vital electrolyte for maintaining proper nerve conduction and muscle function, including the brain. The excessive elimination of potassium through the stool can result in hypokalemia, which is associated with neurological symptoms such as confusion. The equation K+ = Na+ - Cl- + HCO3- highlights the intricate balance of electrolytes, and disruption in this balance can have significant neurological consequences.
Monitoring the patient's serum electrolyte levels, especially potassium, is crucial in preventing adverse effects of lactulose therapy. The nurse should be vigilant for signs of hypokalemia, such as confusion, weakness, and cardiac arrhythmias. Prompt intervention, such as adjusting lactulose dosage or providing potassium supplementation, is essential to ensure the patient's safety and optimal therapeutic outcomes.So, Option D is correct.