Final answer:
The nurse should instruct the client with cirrhosis and low clotting factors to report any signs of bleeding, due to the elevated risk of hemorrhage. While maintaining a balanced diet, including foods with vitamin K, is essential, monitoring for bleeding is a critical immediate concern.
Step-by-step explanation:
A client with cirrhosis of the liver displays a prolonged prothrombin time and a low platelet count. Given the seriousness of these conditions, where clotting factors are likely deficient and there's an increased risk of bleeding, the most important nursing instruction is to report signs of bleeding, no matter how slight. As these patients may be taking medications like aspirin or Coumadin that can exacerbate bleeding risks, it's crucial that the nurse informs the client about the potential hazards and tells them to be vigilant about any bleeding symptoms, which can indicate a need for immediate medical attention.
It is also important for the nurse to educate the client about the significance of vitamin K. Vitamin K is essential for the synthesis of certain coagulation factors, and its deficiency can contribute to increased clotting time, making even minor injuries potentially serious. However, clients should not avoid foods high in vitamin K without professional dietary advice, as this could negatively impact their condition.
In summary, while monitoring dietary intake is important, the immediate concern for this client is to ensure that they understand the importance of identifying and reporting any bleeding episodes, as this could indicate a critical need for medical intervention.