A nurse is caring for a client who has hepatic encephalopathy. Which off the following laboratory values should the nurse monitor?

Rationale: A. Calcium levels are not the primary indicator of hepatic encephalopathy. While liver disease can contribute to various electrolyte imbalances, calcium is not the key laboratory value used to monitor or diagnose hepatic encephalopathy. B. Potassium may be affected in liver disease due to diuretics or fluid shifts, but it is not the defining or most important marker for hepatic encephalopathy. It is monitored for overall metabolic stability, not specifically for encephalopathy severity. C. Blood glucose should be monitored in clients with liver disease because the liver plays a role in glucose regulation. However, it is not the primary diagnostic or monitoring marker for hepatic encephalopathy. D. Elevated serum ammonia levels are strongly associated with hepatic encephalopathy. When the liver is unable to properly convert ammonia (a byproduct of protein metabolism) into urea for excretion, ammonia accumulates in the bloodstream and crosses the blood-brain barrier, leading to neurotoxic effects such as confusion, asterixis, and altered level of consciousness. Monitoring ammonia helps assess severity and response to treatment (e.g., lactulose, rifaximin).