Question

A client with cirrhosis of the liver is having numerous, liquid, incontinent stools, and continues to be confused. In reviewing the client's laboratory studies, the nurse identifies an elevated serum ammonia level. Based on this finding, which prescription is most important for the client to receive?

a. Furosemide
b. Lactulose
c. Loperamide
d. IV human albumin

Answer 1

Intravenous human albumin is crucial for a cirrhosis patient with elevated ammonia levels and symptoms of hepatic encephalopathy, as it helps reduce toxicity by binding substances and supporting essential physiological processes.

Step-by-step explanation:

A patient with cirrhosis of the liver and symptoms of hepatic encephalopathy, such as confusion and liquid stool incontinence, who presents with an elevated serum ammonia level would benefit most from receiving intravenous human albumin. This treatment helps to reduce serum ammonia levels by providing a higher level of albumin, which, due to its molecular properties, can help bind substances and reduce toxicity.

Given the albumin's role in the body and the potential for ammonia intoxication in cirrhosis, which can lead to flapping tremor, slurred speech, blurred vision, and in severe cases, coma and death, maintaining an adequate albumin level is crucial for the patient's recovery.

Moreover, albumin synthesis is often impaired in liver disorders, leading to its decreased concentration in the blood. The administration of IV human albumin supports the body's capacity to handle the toxic byproducts of protein metabolism, such as ammonia, by helping to maintain oncotic pressure and prevent fluid accumulation, as seen in ascites, commonly associated with cirrhosis.