Final answer:
For a client with advanced cirrhosis of the liver, the nursing diagnosis of Fluid volume excess: ascites should take priority due to the immediate health risks and discomfort it causes. Management includes dietary adjustments, medication, and monitoring for infections. Other important diagnoses to consider are risk for hemorrhage and altered nutrition.
Step-by-step explanation:
Prioritizing Nursing Diagnoses for Cirrhosis
When caring for a client with advanced cirrhosis of the liver, the nursing diagnosis that should take priority is Fluid volume excess: ascites. Ascites is the accumulation of fluid in the peritoneal cavity, which is a common complication of cirrhosis and can lead to a decreased quality of life and increased risk of infection. Cirrhosis is a condition characterized by the formation of fibrous tissue in the liver, replacing dead liver cells due to factors such as viral hepatitis, excessive alcohol intake, and exposure to liver-toxic chemicals. In advanced stages, cirrhosis can lead to complications such as hepatic encephalopathy, increased risk of bleeding and hemorrhage, malnutrition, and hepatorenal syndrome. During acute liver failure, a rapid decline in liver function occurs, leading to hepatic encephalopathy and decreased production of vital proteins.
Managing ascites is essential because it can cause discomfort, affect breathing, and be an indicator of poor prognosis. Treatment for ascites may include dietary sodium restriction, diuretics, and in some cases, paracentesis to remove excess fluid. Monitoring for potential complications, such as spontaneous bacterial peritonitis, is also crucial.
The nursing diagnosis of Risk for injury: hemorrhage and Altered nutrition: less than body requirements are also important considerations for a client with cirrhosis. These issues are secondary to the immediate concern of fluid volume excess associated with ascites, but must be addressed as part of the comprehensive care plan.