An adult male client with recurrent ascites from cirrhosis tells the home health nurse that he has no appetite or energy. The nurse should provide which diet suggestions for this client? Select all that apply.
Eat concentrated sweets for a quick energy boost.
Avoid adding salt to foods when cooking or at the table.
Limit helpings of fresh fruits and vegetables.
Choose small helpings of lean protein such as legumes.
Try to eat at least six small meals daily.
Correct Answer : B,D,E
Choice A reason: Concentrated sweets may provide a temporary energy spike, but they lack nutritional value and can exacerbate insulin resistance and hepatic stress. In clients with cirrhosis, maintaining stable blood glucose and avoiding excessive simple sugars is recommended to prevent hepatic encephalopathy and metabolic complications.
Choice B reason: Sodium restriction is critical in managing ascites. Excess sodium promotes fluid retention, worsening abdominal distension and respiratory compromise. Avoiding added salt helps maintain fluid balance and reduces the need for diuretics or paracentesis.
Choice C reason: Fresh fruits and vegetables are essential for providing vitamins, minerals, and fiber. Limiting them would deprive the client of necessary nutrients and contribute to fatigue and poor immune function. Unless contraindicated due to potassium levels or specific hepatic complications, they should be encouraged.
Choice D reason: Lean protein sources like legumes are important for maintaining muscle mass and immune function in cirrhotic patients. Protein should be provided in small, frequent portions to avoid overwhelming hepatic metabolism while preventing protein-calorie malnutrition.
Choice E reason: Eating six small meals daily helps manage early satiety caused by ascites, improves nutrient absorption, and stabilizes energy levels. It also reduces the metabolic burden on the liver by spreading intake throughout the day.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Seatbelt campaigns are important for vehicle safety but do not directly impact pedestrian safety for children walking to school. The focus should be on protecting children in transit, not drivers.
Choice B reason: Designated safe houses provide children with secure locations to seek help if they feel threatened or unsafe while walking. This strategy directly enhances pedestrian safety and community engagement.
Choice C reason: Lead inspections are important for environmental health but are unrelated to the immediate safety of children walking to and from school. This action does not address the PTO’s goal.
Choice D reason: Keeping porch lights on improves visibility and may deter crime, but it is a passive measure. It does not offer direct support or protection for children in distress.
Correct Answer is D
Explanation
Choice A reason: Rechecking vital signs in 30 minutes delays critical intervention. The client is showing signs of a potentially life-threatening postoperative complication such as an anastomotic leak or internal hernia, which can rapidly deteriorate. Delaying action could result in worsening sepsis or bowel ischemia.
Choice B reason: While assessing oxygen saturation is part of a comprehensive evaluation, it does not address the underlying cause of the symptoms. The client’s fever, tachycardia, hypotension, and referred shoulder pain suggest peritoneal irritation and possible sepsis, which require immediate transport and surgical evaluation.
Choice C reason: Instructing the client to drive themselves is unsafe. The client is hemodynamically unstable and may deteriorate en route. Driving could delay care and increase risk of injury or death.
Choice D reason: Transporting the client via ambulance ensures rapid access to emergency care and allows for monitoring during transit. The symptoms are consistent with a surgical emergency such as an anastomotic leak or internal hernia, which require prompt imaging and possible surgical intervention.
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