A nurse teaches a wilderness survival class. Which statement should the nurse include about the prevention of cold-related injuries?

Rationale:

A. Renal function tests are essential to monitor in a client with cirrhosis receiving diuretics (such as spironolactone or furosemide). Diuretics increase urine output and can reduce circulating volume, potentially leading to dehydration and renal impairment. Clients with cirrhosis are already at risk for hepatorenal syndrome. Monitoring BUN and creatinine helps detect worsening kidney function early and prevents serious complications. This is directly related to diuretic therapy and is a priority.

B. Body image disturbances may occur due to ascites and abdominal distention, but this is a psychosocial concern related to the disease process itself—not a direct effect of diuretic therapy. While important for holistic care, it is not a priority assessment specific to medication safety.

C. Gastrointestinal bleeding is a serious complication of cirrhosis (often due to varices), but it is not directly caused by diuretic therapy. Monitoring for GI bleeding is important in cirrhosis overall; however, it is not specifically related to evaluating the effects or safety of diuretics.

D. Electrolyte laboratory results are critically important when a client is taking diuretics. Diuretics can cause significant electrolyte imbalances such as hypokalemia (with loop diuretics) or hyperkalemia (with potassium-sparing diuretics like spironolactone). Sodium levels may also decrease. Electrolyte disturbances can lead to cardiac dysrhythmias and neurological changes, making this a priority safety concern.

E. Increased clotting tendencies are not expected in cirrhosis; in fact, clients with cirrhosis are more likely to have decreased clotting due to reduced production of clotting factors by the liver. This finding is unrelated to diuretic therapy and is not a priority assessment in this context.

Rationale:

A. This is incorrect because alcohol is directly toxic to the liver. Even during an acute hepatitis B infection, consuming alcohol can worsen liver inflammation, prolong recovery, and increase the risk of complications. The nurse should instruct the client to completely avoid alcohol to protect liver function and promote healing.

B. This is incorrect because hepatitis B has a relatively long incubation period, typically ranging from 6 weeks to 6 months. Misunderstanding the incubation period could lead the client to misinterpret the timing of symptom onset or the risk of transmitting the virus to others. Accurate knowledge helps clients monitor symptoms and understand the course of illness.

C. Chronic hepatitis B infection is a well-established risk factor for cirrhosis and hepatocellular carcinoma. Educating clients about these long-term risks is essential so they understand the importance of follow-up care, liver function monitoring, and lifestyle modifications.

D. In adults, about 90% of acute hepatitis B infections resolve spontaneously, with the immune system clearing the virus. Clients who recover develop immunity, which provides protection against future infections. This statement provides reassurance, emphasizes a positive prognosis, and is accurate for client education. It also helps reduce anxiety associated with a new diagnosis and encourages adherence to follow-up care.