A nurse is caring for a client who has advanced liver disease. Which of the following laboratory results should the nurse monitor when assessing this client?

A. Glucose level is incorrect as the primary lab to monitor for advanced liver disease, though the liver does play a role in glucose metabolism. Hypoglycemia can occur in severe liver disease, but it is not the most specific or critical marker for monitoring disease progression or complications. B. Serum troponin is incorrect because troponin is a cardiac biomarker used to assess myocardial injury, not liver function. It does not provide relevant information for monitoring advanced liver disease. C. Phosphate level is incorrect. Phosphate is more relevant in renal function or metabolic disorders. While electrolyte imbalances can occur in liver disease, phosphate is not a primary marker to assess the liver’s function or complications. D. Serum ammonia is correct. Advanced liver disease can impair the liver’s ability to metabolize ammonia, leading to hyperammonemia. Elevated serum ammonia levels can indicate hepatic encephalopathy, a serious complication of liver failure. Monitoring this lab helps guide interventions such as lactulose administration and dietary adjustments to reduce ammonia levels and prevent neurologic deterioration.