The nurse assesses a client with cirrhosis who is prescribed diuretics for ascites. Which assessment findings are most important for the nurse to evaluate related to diuretic therapy? Select all that apply.

Rationale: A. Renal function tests are essential to monitor in a client with cirrhosis receiving diuretics (such as spironolactone or furosemide). Diuretics increase urine output and can reduce circulating volume, potentially leading to dehydration and renal impairment. Clients with cirrhosis are already at risk for hepatorenal syndrome. Monitoring BUN and creatinine helps detect worsening kidney function early and prevents serious complications. This is directly related to diuretic therapy and is a priority. B. Body image disturbances may occur due to ascites and abdominal distention, but this is a psychosocial concern related to the disease process itself—not a direct effect of diuretic therapy. While important for holistic care, it is not a priority assessment specific to medication safety. C. Gastrointestinal bleeding is a serious complication of cirrhosis (often due to varices), but it is not directly caused by diuretic therapy. Monitoring for GI bleeding is important in cirrhosis overall; however, it is not specifically related to evaluating the effects or safety of diuretics. D. Electrolyte laboratory results are critically important when a client is taking diuretics. Diuretics can cause significant electrolyte imbalances such as hypokalemia (with loop diuretics) or hyperkalemia (with potassium-sparing diuretics like spironolactone). Sodium levels may also decrease. Electrolyte disturbances can lead to cardiac dysrhythmias and neurological changes, making this a priority safety concern. E. Increased clotting tendencies are not expected in cirrhosis; in fact, clients with cirrhosis are more likely to have decreased clotting due to reduced production of clotting factors by the liver. This finding is unrelated to diuretic therapy and is not a priority assessment in this context.