A 34-year-old male client has diagnoses of liver failure, ascites, and hepatic encephalopathy secondary to alcohol abuse. The client's family is questioning the care team as to why his abdomen is so large even though he is undernourished and emaciated. Which of the following statements most accurately underlies the explanation that a member of the care team would provide the family?

Correct Answer: C

Rationale: The correct answer is C: Normally small transcellular fluid compartment, or third space, is becoming enlarged. In liver failure with ascites, there is an abnormal accumulation of fluid in the peritoneal cavity due to low oncotic pressure from decreased albumin production by the liver. This results in an enlarged transcellular fluid compartment, known as the "third space," leading to the distended abdomen. Options A, B, and D are incorrect because they do not accurately explain the specific fluid compartment enlargement seen in ascites related to liver failure. Option A refers to interstitial fluid, not the transcellular compartment. Option B incorrectly mentions the intracellular fluid compartment, which is not the primary issue in ascites. Option D incorrectly refers to plasma accumulating in the peritoneal cavity, which is not the mechanism behind the abdominal distension in this case.

Correct Answer: B

Rationale: The correct answer is B: Regular insulin infusion, rate dependent on lab values. Insulin drives potassium into cells, lowering serum levels. In this case of severe hyperkalemia, urgent intervention is required. The nurse should administer insulin to lower potassium levels quickly. Options A, C, and D are incorrect as they do not directly address the hyperkalemia. Lactated Ringer solution does not specifically address hyperkalemia. Solu-Medrol is a steroid and Dilaudid is a pain medication, neither of which treat hyperkalemia.

Correct Answer: B

Rationale: The correct answer is B: Serum potassium 2.8 mEq/L. A low potassium level (hypokalemia) can result from diuretic use, leading to heart rhythm disturbances. Potassium is crucial for proper heart function. Choice A, serum sodium 135 mEq/L, is within normal range and not indicative of a potassium imbalance. Choice C, serum calcium 8.5 mg/dL, and choice D, serum phosphate 3.5 mg/dL, are not directly related to potassium imbalance. Monitoring serum potassium levels is vital in patients on diuretics to prevent potential complications.

Correct Answer: B

Rationale: The correct answer is B: Liver failure. The symptoms of fatigue, weight gain, and decreased albumin levels are indicative of liver failure. Liver failure can lead to decreased albumin synthesis, causing fluid accumulation in the body leading to swelling in the legs. Chronic kidney disease (A) typically presents with other symptoms like elevated creatinine levels. Congestive heart failure (C) usually presents with symptoms like shortness of breath and edema, but not typically low albumin levels. Hypothyroidism (D) can cause fatigue and weight gain, but it does not directly lead to decreased albumin levels and leg swelling.

Correct Answer: A

Rationale: Ideal body weight is the weight associated with optimal health, not a fixed standard or subjective feeling.