A nurse is caring for a newly admitted client. A nurse notes the client's condition and initiates the following action. Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.

Potential Condition: Encephalopathy Rationale: The client is disoriented and agitated, with a history of cirrhosis and significantly elevated ammonia (236 mcg/dL), which are hallmark signs of hepatic encephalopathy. Other lab abnormalities (elevated AST, ALT, bilirubin, low albumin) support advanced liver dysfunction. Actions to Take: Administer lactulose as prescribed – Lactulose reduces ammonia absorption in the gut, helping to lower serum ammonia levels and improve mental status in hepatic encephalopathy. Monitor hematemesis – Clients with liver disease are at risk for gastrointestinal bleeding due to esophageal varices; monitoring for vomiting of blood is crucial to prevent complications. Parameters to Monitor: Safety measures – Because the client is disoriented and at risk for falls or injury, monitoring safety is essential. Intake and output – Monitoring fluid balance is critical in clients with liver disease to assess for dehydration, electrolyte imbalance, and response to therapies like lactulose.