The nurse is caring for a client with a history of cirrhosis of the liver. Lab values reveal rising ammonia levels. Which of the following actions should the nurse anticipate performing? Select all that apply.

  • replace electric razor with a straight razor
  • encourage frequent periods of rest
  • instruct on a potassium-restricted diet
  • monitor the client’s mental status
Numbers 2 and 4 are correct.
Due to diffuse destruction of hepatic cells with cirrhosis of the liver, the client will experience fatigue and need frequent rest periods throughout the day. An inability of the liver to filter toxins can lead to hepatic encephalopathy making assessment of the client’s mental status imperative. Due to impaired clotting function, clients need safety measures implemented such as replacing a straight shaving razor with an electric one. Sodium rather than potassium should be restricted with cirrhosis of the liver.