NCLEX-PN® ExaminationPhysiological AdaptationMedium
A client with a history of liver cirrhosis is admitted with ascites and confusion. The nurse suspects hepatic encephalopathy. Which dietary modification is most appropriate for this client?
- AHigh-carbohydrate diet to provide energy.
- BHigh-protein diet to support liver regeneration.
- CLow-sodium diet to reduce fluid retention.
- DLow-protein diet to decrease ammonia production.
Show answer & explanationAnswer & explanation
Correct answer: D. Low-protein diet to decrease ammonia production.
Hepatic encephalopathy is a neuropsychiatric complication of liver cirrhosis caused by the accumulation of toxins, primarily ammonia, which the damaged liver cannot metabolize. Ammonia is a byproduct of protein metabolism. Therefore, a low-protein diet is prescribed to decrease the amount of ammonia produced, thereby reducing the neurological symptoms of encephalopathy.
Why the other options are wrong
- A. A high-carbohydrate diet is generally part of the dietary management but not the most appropriate modification specifically for hepatic encephalopathy symptoms like confusion.
- B. A high-protein diet would increase ammonia production, worsening hepatic encephalopathy.
- C. A low-sodium diet is appropriate for ascites but does not directly address hepatic encephalopathy.
Dietary Management of Hepatic Encephalopathy
Nutritional adjustments aimed at reducing ammonia levels in clients with advanced liver disease and hepatic encephalopathy to mitigate neurological symptoms.
- Hepatic encephalopathy is caused by accumulation of ammonia and other toxins.
- Ammonia is a byproduct of protein metabolism.
- Dietary protein restriction is a key intervention to reduce ammonia production.
- Adequate calories from carbohydrates and fats are still essential to prevent protein catabolism.
Memory trick: Confused Liver? Low Protein, Less Ammonia!