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一位接受乳果糖治療肝門體循環腦病變的病人。請審查趨勢並選擇最佳的解釋和計畫。

Trend

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Time	Data
Before therapy adjustment	Confused; no bowel movement; sodium 138 mEq/L; potassium 4.0 mEq/L意識混亂；無排便；鈉 138 mEq/L；鉀 4.0 mEq/L
Desired response	Alert; 3 soft stools in 24 hours; oral intake maintained警覺；24 小時內 3 次軟便；維持口服攝取
Current reassessment	8 watery stools in 24 hours; BP 88/52 mm Hg; sodium 150 mEq/L; potassium 3.0 mEq/L24 小時內 8 次水樣便；血壓 88/52 mm Hg；鈉 150 mEq/L；鉀 3.0 mEq/L

Q1. How should the current trend be interpreted?目前的趨勢應如何解釋？

Desired maintenance response預期的維持反應 Excessive lactulose effect with volume and electrolyte loss乳果糖作用過度，導致體液和電解質流失 Expected permanent cure of liver disease預期肝病永久治癒

Q2. Which plan is appropriate?哪項計畫是適當的？

Hold and clarify dosing, assess perfusion, and replace ordered fluids and electrolytes暫停並釐清劑量，評估灌注，並補充醫囑的體液和電解質 Increase lactulose until all stools are liquid增加乳果糖劑量直到所有糞便都呈液狀 Ignore the findings because mental status improved忽略這些發現，因為精神狀態已改善

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