Which nursing interventions should the Registered Nurse implement when providing care for a patient with ascites related to Cirrhosis of the liver? (Select all that apply.)

Choice A rationale Administering furosemide, a loop diuretic, as prescribed is a key intervention to manage ascites by promoting the excretion of excess fluid and sodium. Diuretics work by inhibiting sodium reabsorption in the loop of Henle, which in turn reduces the fluid volume in the interstitial spaces, including the peritoneal cavity, decreasing abdominal girth. Choice B rationale Ambulation should be limited in patients experiencing significant ascites because the increased intra-abdominal pressure from the fluid makes breathing and movement difficult and uncomfortable. Excessive activity can increase metabolic demands and may exacerbate the compromised respiratory status caused by the elevated diaphragm. Bed rest is often preferred. Choice C rationale Maintaining strict intake and output (I O) is essential for monitoring the effectiveness of diuretic therapy and the overall fluid balance. Accurate I O tracking, along with daily weights, helps the nurse determine if the patient is mobilizing and excreting the ascetic fluid effectively while avoiding complications like dehydration or electrolyte imbalances. Choice D rationale Preparing the patient for a paracentesis is an important intervention when ascites is severe, causing respiratory distress, or is refractory to diuretic treatment. This procedure involves the aspiration of fluid from the peritoneal cavity to temporarily relieve pressure and discomfort, which significantly improves the patient's respiratory function. Choice E rationale Encouraging an increase in oral fluids is contraindicated for a client with ascites related to cirrhosis because the underlying pathology often involves hyperaldosteronism and an inability to excrete free water. Increasing fluid intake would exacerbate the fluid volume excess and worsen the ascites and potentially lead to dilutional hyponatremia.