A nurse is reinforcing teaching with a client who has cirrhosis of the liver. Which of the following statements should be included in the education materials?

Brief Introduction: Cirrhosis involves progressive parenchymal destruction where healthy hepatocytes are replaced by fibrotic tissue, severely impairing metabolic functions. This architectural distortion leads to portal hypertension, resulting in complications such as esophageal varices, coagulopathy, and hepatic encephalopathy due to hyperammonemia. Rationale: A. Excessive physical exertion can exacerbate fatigue and increase portal pressure in patients with advanced liver disease. Activity must be balanced with rest to minimize metabolic demands on the liver. Clients often require a tailored exercise plan to prevent muscle wasting while avoiding injury. B. Acetaminophen is primarily metabolized by the liver and can cause hepatotoxic injury even at therapeutic doses in cirrhotic patients. Nonsteroidal anti-inflammatory drugs are also contraindicated due to the risk of gastrointestinal hemorrhage. Providers must strictly monitor all pharmacological interventions for safety. C. Sodium restriction is essential to manage fluid retention and minimize extracellular volume expansion associated with hypoalbuminemia. Restricting intake to < 2000 mg daily helps control ascites and edema. Avoiding processed foods reduces the risk of life-threatening fluid overload and respiratory distress. D. Consuming three large meals can cause significant abdominal discomfort and early satiety due to gastric compression from ascites. Patients should consume small frequent meals to ensure adequate caloric intake and prevent protein-calorie malnutrition. Smaller portions also help maintain stable blood glucose levels.