Question

a 57-year-old woman with cirrhosis complains of worsening distension of the abdomen and edema up to her lower legs despite compliance with eating less than 2 grams daily of sodium. she denies abdominal pain, constipation, dyspnea or fevers. on exam, her abdomen is distended and has a notable fluid wave. she has 2 pitting edema to the level of her ankles. which medication is the most appropriate next step in the management of this patient?

Answer 1

Based on the given information, the most appropriate next step in the management of this patient would be Spironolactone

Step-by-step explanation:

Spironolactone is a potassium-sparing diuretic that works by blocking the effects of aldosterone, a hormone involved in fluid and electrolyte balance. It helps to reduce fluid accumulation and edema in patients with cirrhosis. By inhibiting the reabsorption of sodium and water while promoting the excretion of potassium, spironolactone can help alleviate the patient's symptoms of abdominal distension and peripheral edema.

Answer 2

The most appropriate next step in the management of this patient would be the prescription of a diuretic (water pill). This medicine will help to reduce the swelling by removing excess fluid from the patient’s body. However, it is important to monitor the patient’s fluid balance carefully to ensure that she does not become dehydrated. Additionally, it is important to encourage the patient to continue limiting her sodium intake since excess sodium intake can cause fluid retention and worsening edema.