A nurse is assessing a client who has advanced cirrhosis. Which of the following manifestations should the nurse expect to find?

Choice A: Place the client on bedrest. This is not an intervention that the nurse should include in the plan of care for a client who has hypothyroidism with myxedema. Placing the client on bedrest can increase the risk of complications such as thromboembolism, pressure ulcers, and muscle atrophy. The nurse should encourage the client to perform gentle exercises and change positions frequently.

Choice B: Apply warm blankets. This is an intervention that the nurse should include in the plan of care for a client who has hypothyroidism with myxedema. Hypothyroidism is a condition that occurs when the thyroid gland does not produce enough thyroid hormone. Thyroid hormone regulates the metabolism of carbohydrates, proteins, and fats, and affects the energy expenditure and body temperature. Myxedema is a severe form of hypothyroidism that causes swelling of the skin and tissues due to accumulation of mucopolysaccharides. Applying warm blankets can help maintain the client’s body temperature and prevent hypothermia, which is a low body temperature.

Choice C: Check the client for weight loss. This is not an intervention that the nurse should include in the plan of care for a client who has hypothyroidism with myxedema. Checking the client for weight loss can indicate hyperthyroidism, which is a condition that occurs when the thyroid gland produces too much thyroid hormone.

Hyperthyroidism can cause weight loss due to increased metabolic rate and appetite. The nurse should check the client for weight gain, which can indicate hypothyroidism due to decreased metabolic rate and fluid retention.

Choice D: Limit high-fiber foods. This is not an intervention that the nurse should include in the plan of care for a client who has hypothyroidism with myxedema. Limiting high-fiber foods can cause constipation, which can worsen hypothyroidism symptoms such as bloating, abdominal pain, and fatigue. The nurse should encourage the client to eat high-fiber foods, such as fruits, vegetables, and whole grains, to promote bowel regularity and prevent constipation.

Choice A: Faty stools. This is a finding that is expected for a client who has obstruction and inflammation of the common bile duct due to cholelithiasis, which is the presence of gallstones in the gallbladder or bile ducts. The common bile duct carries bile from the liver and gallbladder to the duodenum, where it helps digest fats. If the common bile duct is obstructed by a gallstone, bile cannot reach the duodenum and fats cannot be properly absorbed. This results in fatty stools, which are also known as steatorrhea. Fatty stools are pale, bulky, greasy, and foul-smelling.

Choice B: Ecchymosis of the extremities. This is not a finding that is expected for a client who has obstruction and inflammation of the common bile duct due to cholelithiasis. Ecchymosis of the extremities is a sign of bleeding under the skin, which can be caused by trauma, coagulation disorders, or medications. It is not related to bile duct obstruction or gallstones.

Choice C: Straw-colored urine. This is not a finding that is expected for a client who has obstruction and inflammation of the common bile duct due to cholelithiasis. Straw-coloured urine is a normal colour of urine, which indicates adequate hydration and kidney function. It is not affected by bile duct obstruction or gallstones.

Choice D: Tenderness in the left upper abdomen. This is not a finding that is expected for a client who has obstruction and inflammation of the common bile duct due to cholelithiasis. Tenderness in the left upper abdomen is a sign of splenomegaly, which is an enlargement of the spleen due to infection, inflammation, or cancer. It is not related to bile duct obstruction or gallstones.