A client with decompensated cirrhosis presents with new ascites, abdominal pain, fever 38.4 C, confusion, and asterixis. Which interventions should the nurse anticipate? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Decompensated cirrhosis with new ascites and fever requires diagnostic paracentesis with PMN count over 250 confirming SBP — empiric ceftriaxone or cefotaxime is started. IV albumin (1.5 g/kg day 1, 1 g/kg day 3) reduces hepatorenal syndrome and mortality in SBP. Hepatic encephalopathy is treated with lactulose titrated to 3-4 soft stools per day plus rifaximin for resistant cases. Severe protein restriction is OUTDATED and worsens malnutrition — modest restriction (1.0-1.5 g/kg/day plant-protein-rich) is acceptable.