Which of the following must be immediately performed in a patient who has just been intubated? (select all that apply)

A. Inability of the liver to manufacture bile: This does not directly cause esophageal varices or bleeding.

B. A scarred liver results in Portal Hypertension: Cirrhosis leads to scarring of the liver, which increases resistance to blood flow and causes portal hypertension. This elevated pressure in the portal venous system leads to the development of esophageal varices, which can rupture and bleed.

C. An elevated level of copper: Elevated copper levels are associated with Wilson's disease, not the cause of esophageal variceal bleeding in cirrhosis.

D. Inability of the liver to convert NH3 to urea: This causes hepatic encephalopathy but is not related to variceal bleeding.

A. Ask a family member to interpret what the client is trying to communicate: While family members can sometimes help, the nurse should directly facilitate communication with the client using appropriate tools.

B. Ask the physician to wean the client off the mechanical ventilator to allow the client to talk: Weaning off a ventilator should only be done based on medical stability, not solely for communication purposes.

C. Ask the client to write, use a picture board, or spell words with an alphabet board: These tools can help non-verbal clients on mechanical ventilation express themselves and reduce frustration.

D. Assure the client that everything will be all right and that he shouldn't become upset: This response is dismissive and does not address the client's need to communicate.