A client with liver cirrhosis presents with confusion, lethargy, and asterixis. Which complication is the client most likely experiencing?

Liver cirrhosis leads to progressive liver dysfunction, reducing the organ’s ability to detoxify harmful substances such as ammonia. When toxins accumulate in the bloodstream and cross the blood-brain barrier, they affect central nervous system function. This results in neuropsychiatric changes ranging from mild confusion to coma. Clinical signs such as asterixis, altered mental status, and lethargy are hallmark features of this complication. Rationale: A. Hepatic encephalopathy is the correct complication because it results from the accumulation of neurotoxic substances, particularly ammonia, due to impaired liver detoxification in cirrhosis. The client’s confusion, lethargy, and asterixis (flapping tremor) are classic neurological manifestations. These findings indicate altered cerebral function secondary to hepatic failure. B. Ascites refers to the accumulation of fluid in the peritoneal cavity due to portal hypertension and hypoalbuminemia. While it is a common complication of cirrhosis, it primarily presents as abdominal distension and weight gain rather than neurological changes. It does not explain confusion or asterixis. C. Portal hypertension is increased pressure within the portal venous system caused by resistance to blood flow through the diseased liver. Although it leads to complications such as variceal bleeding and ascites, it is a vascular condition and does not directly cause neurological symptoms like confusion or asterixis. D. Jaundice results from the accumulation of bilirubin due to impaired hepatic metabolism and excretion. It is characterized by yellowing of the skin and sclera but does not typically cause acute changes in mental status or neuromuscular findings such as asterixis.