A nurse is caring for a patient who has cirrhosis of the liver and is having difficulty eliminating alcohol consumption because many of their friends drink alcohol socially.
Which of the following steps should the nurse include to motivate the patient to change?

Choice A rationale

While a 25-year-old planning to lose 20 pounds after childbirth may have increased nutritional needs, they would not typically be considered at higher risk for malnutrition unless there were other factors such as inadequate diet or certain health conditions.
Choice B rationale
A 65-year-old who recently underwent hernia surgery might have temporary changes in diet or appetite related to the surgery, but would not typically be at high risk for malnutrition unless there were other ongoing issues such as poor diet, difficulty eating, or a chronic health condition.
Choice C rationale
A 70-year-old who has been fasting since midnight in preparation for a colonoscopy would not typically be at risk for malnutrition from this short-term fast. However, if they had ongoing issues with diet, appetite, or a chronic health condition, they could potentially be at risk.
Choice D rationale
A 55-year-old who has been consuming alcohol for 35 years is at higher risk for malnutrition. Alcohol can interfere with the body’s ability to absorb and use nutrients, and individuals with long-term heavy alcohol use may also have other lifestyle factors that increase their risk for malnutrition.

Choice A rationale
While bleeding precautions are important in certain conditions, they may not be the priority for a patient with significant abdominal ascites. Ascites, the accumulation of fluid in the peritoneal cavity, is often caused by liver disease such as cirrhosis.
Choice B rationale
Skin safety protocols are important for all patients, but they may not be the priority in this case. Ascites can cause discomfort and other complications, but it does not directly cause skin problems.
Choice C rationale
A sodium restriction diet can be beneficial for patients with ascites, as it can help reduce fluid accumulation. However, this measure may not be the priority in this case.
Choice D rationale
Implementing a fall risk protocol should be prioritized. The patient’s significant abdominal ascites could affect their balance and mobility, increasing their risk of falls. Furthermore, the patient usually uses a cane for support but forgot to bring it to the hospital, further increasing their fall risk.