Order: Octreotide continuous infusion via pump at 50 mcg/hour Available: Octreotide 0.5 mg in 100 mL of fluid Infuse at 

A. Avoid positioning the client supine: Orthopnea is the inability to breathe comfortably while lying flat, so the nurse should avoid placing the client in a supine position and instead elevate the head of the bed.

B. Limit the client's activity level: While activity may need to be adjusted, this is not the primary concern for orthopnea.

C. Administer supplemental oxygen at all times: Oxygen may be necessary, but the key issue with orthopnea is the need to avoid lying flat, not necessarily the need for constant supplemental oxygen.

D. Teach the client deep breathing and coughing exercises: While beneficial for other conditions, this does not directly address orthopnea, which is primarily positional.

A. PT/INR: PT/INR is used to assess clotting function and liver synthetic function but does not directly relate to the symptoms of lethargy and confusion.

B. Urea: Urea levels are related to kidney function and protein metabolism but do not directly explain the symptoms of encephalopathy.

C. Ammonia: Elevated ammonia levels in cirrhosis can lead to hepatic encephalopathy, which presents as lethargy and confusion. The liver is unable to convert ammonia to urea, leading to its accumulation in the blood.

D. Albumin: Albumin levels are important in assessing nutritional status and fluid balance in cirrhosis but do not directly cause lethargy and confusion.