Editing Nutrition – RN Practice Questions (section)

==Question 14==
A nurse is caring for a client with hepatic cirrhosis and ascites. Which components should the nurse expect in the prescribed nutrition plan? '''Select all that apply.'''
# Sodium restriction
# Fluid restriction if hyponatremia is present
# Complete elimination of all dietary protein
# Small frequent meals with a late evening snack
# Adequate calorie intake to prevent muscle catabolism

'''Answer:''' 1, 2, 4, and 5.

''Rationale:'' Sodium restriction is the cornerstone of ascites management, and fluid is restricted when dilutional hyponatremia develops. Clients with cirrhosis have accelerated fasting metabolism, so small frequent meals with a late evening carbohydrate and protein snack reduce overnight catabolism, and adequate calories preserve lean mass. Option 3 reflects outdated practice. Blanket protein elimination is no longer recommended, because these clients are typically protein depleted and restriction accelerates sarcopenia and worsens outcomes. Protein is provided at adequate levels, and hepatic encephalopathy is managed with lactulose and rifaximin rather than by starving the client of protein.