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Question 2: A client with cirrhosis of the liver becomes comatose and is started on neomycin 300 mg q6h
via nasogastric tube. The rationale for this therapy is to:
A. Prevent systemic infection
B. Promote diuresis
C. Decrease ammonia formation
D. Acidify the small bowel
Correct Answer: C
Explanation:
(A) Neomycin is an antibiotic, but this is not the Rationale for administering it to a client in hepatic
coma. (B) Diuretics and salt-free albumin are used to promote diuresis in clients with cirrhosis of the
liver. (C) Neomycin destroys the bacteria in the intestines. It is the bacteria in the bowel that break
down protein into ammonia. (D) Lactulose is administered to create an acid environment in the
bowel. Ammonia leaves the blood and migrates to this acidic environment where it is trapped and
excreted.
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