The nurse is caring for a client who presents with increased ammonia levels, elevated BUN, and altered mental status. Which medication would the nurse anticipate the health care provider ordering for this client?

  1. lactulose
  2. sucralfate
  3. lamotrigine
  4. gabapentin
Number 1 is correct.
Rationale: Lactulose is a laxative given to lower ammonia levels in clients with hepatic encephalopathy. Elevated BUN indicates a dysfunction in the body’s ability to convert protein to nitrogen; this coupled with elevated ammonia levels would present as confusion. Sucralfate is an anti-ulcer medication used in the management of GI ulcers. Lamotrigine is an antiepileptic medication used to control seizures. Gabapentin is an anticonvulsant and mood stabilizer.