A nurse is caring for a client who has diabetic ketoacidosis (DKA). Which of the following manifestations should the nurse expect?

Choice A reason: A high-sodium diet is contraindicated in cirrhosis, as it promotes fluid retention, worsening ascites and edema. A low-sodium diet is recommended to manage fluid balance, making this choice incorrect for the care plan.

Choice B reason: Daily weighing monitors fluid status in cirrhosis, as weight gain indicates ascites or edema, common complications. This helps assess treatment efficacy, like diuretics, and guides fluid management, making this a correct action.

Choice C reason: Furosemide, a diuretic, reduces ascites and edema in cirrhosis by promoting fluid excretion. It addresses fluid overload, a common issue due to portal hypertension, making this a correct action for the care plan.

Choice D reason: Strenuous exercise is contraindicated in cirrhosis, as it risks variceal bleeding and fatigue due to compromised liver function. Light activity may be encouraged, but strenuous efforts are unsafe, making this choice incorrect.

Choice E reason: Warfarin is contraindicated in cirrhosis, as the liver’s impaired clotting factor synthesis increases bleeding risk. Anticoagulants worsen coagulopathy, particularly with esophageal varices, making this choice incorrect for the care plan.

Choice A reason: Restricting fluid intake does not reduce ammonia levels in hepatic encephalopathy. Fluid management addresses ascites or edema, but ammonia accumulates due to impaired liver metabolism of protein, making fluid restriction irrelevant to the goal of lowering ammonia in cirrhosis.

Choice B reason: Administering furosemide treats ascites or edema in cirrhosis by promoting diuresis but does not directly reduce ammonia levels. Ammonia results from protein metabolism, requiring dietary restriction, not fluid loss, making this an ineffective intervention for encephalopathy.

Choice C reason: Administering vitamin K corrects coagulopathy in cirrhosis by aiding clotting factor synthesis but has no effect on ammonia levels. Ammonia accumulates from protein breakdown, requiring protein restriction, making vitamin K irrelevant to managing encephalopathy’s neurological symptoms.

Choice D reason: Limiting protein intake (20-40 g/day) reduces ammonia in hepatic encephalopathy, as the damaged liver cannot metabolize protein, leading to ammonia accumulation. This intervention minimizes ammonia production, alleviating neurological symptoms like confusion, making it the most effective strategy for this condition.