NurseBeata

I believe the reason why patients are put on precs before infection is to protect other more vulnerable patients with open wounds. I work on a general surgical floor where patients often have open incisions, fistulas, and other large wounds. On a larger scale, visitors who enter contact precaution rooms are advised to wear PPE to prevent carrying antibiotic resistant microbes back to vulnerable populations- like children, the elderly, and the immunocompromised.

I've recently had a similar situation occur. Had a patient with C. diff who was being given lactulose titrated to 3-4 BMs per day. There were several factors that required lactulose treatment: pt had liver damage (hepatic encephalopathy) with high ammonia levels. Where there other pre-existing conditions that might require laxative treatment? There was an issue I didn't quite understand from an interventional standpoint, and if anyone out there could answer this, it would be super helpful. After the patient had ammonia levels checked and they were well within normal limits and they were cleared of C. diff, the doctors continued lactulose treatment. When asked whether the treatment should be discontinued, the resident stated that once patients with hepatic encephalopathy begin lactulose treatment, they do not stop regardless of ammonia levels. They simply follow the patient "clinically." Can anyone explain this rationale?