A nurse cares for a client with hepatic portal-systemic encephalopathy (PSE). The client is thin and cachectic in appearance, and the family expresses distress that the client is receiving little dietary protein. How should the nurse respond?
a. "A low-protein diet will help the liver rest and will restore liver function."
b. "Less protein in the diet will help prevent confusion associated with liver failure."
c. "Increasing dietary protein will help the client gain weight and muscle mass."
d. "Low dietary protein is needed to prevent fluid from leaking into the abdomen."
ANS: B
A low-protein diet is ordered when serum ammonia levels increase and/or the client shows signs of PSE. A low-protein diet helps reduce excessive breakdown of protein into ammonia by intestinal bacteria. Encephalopathy is caused by excess ammonia. A low-protein diet has no impact on restoring liver function. Increasing the client's dietary protein will cause complications of liver failure and should not be suggested. Increased intravascular protein will help prevent ascites, but clients with liver failure are not able to effectively synthesize dietary protein.
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