A nurse is planning care for a dent who has diverticulitis. The nurse should plan to monitor the client for which of the following complications of diverticulitis?

A. Weight loss and malnutrition: IBS does not typically cause weight loss or malnutrition. If a client experiences these symptoms, further evaluation is needed to rule out other conditions such as inflammatory bowel disease (IBD) or malignancy.

B. Alteration between constipation and diarrhea: IBS is characterized by a change in bowel habits, which may include alternating episodes of constipation and diarrhea. This is the correct answer.

C. Severe rectal bleeding: IBS does not cause rectal bleeding. If present, conditions such as hemorrhoids, IBD, or colorectal cancer should be considered.

D. Fever and elevated white blood cell count: IBS does not cause systemic inflammation. Fever and leukocytosis are more indicative of infections or inflammatory disorders like ulcerative colitis or Crohn's disease.

The client's ammonia level is critically elevated (250 mcg/dL), which can lead to altered mental status, confusion, and lethargy, consistent with hepatic encephalopathy. In cirrhosis, the liver loses its ability to detoxify ammonia, leading to its accumulation in the bloodstream. This excess ammonia crosses the blood-brain barrier, impairing neuronal function and causing hepatic encephalopathy.

Incorrect answers:

DKA is characterized by high blood glucose (>250 mg/dL), metabolic acidosis, and ketonemia. This client has a moderate glucose elevation (148 mg/dL) but no signs of acidosis, Kussmaul respirations, or ketonuria.

Dehydration: While dehydration can contribute to mental status changes, severe hyperammonemia is a direct cause of hepatic encephalopathy. The client's crackles in the lungs and peripheral edema suggest fluid retention, not dehydration.

Acute kidney disease presents with rising creatinine levels, oliguria, and electrolyte imbalances. This client’s creatinine level is normal, ruling out acute kidney disease.

Malnutrition is characterized by low albumin, muscle wasting, and weight loss, but this client's elevated glucose is more likely due to diabetes mellitus rather than malnutrition.