A nurse is planning care for a client who has cirrhosis and ascites.
Which of the following interventions should the nurse include in the plan of care?

Choice A rationale
While a nasogastric tube can be used to determine the pH of gastric secretions, this is not typically the primary reason for its use in the treatment of pyloric obstruction.
Choice B rationale
While nasogastric tubes can be used to supply nutrients via tube feedings, this is not typically the primary reason for its use in the treatment of pyloric obstruction. In the case of pyloric obstruction, the focus is usually on relieving the obstruction rather than on feeding.
Choice C rationale
While nasogastric tubes can be used to administer medications, this is not typically the primary reason for its use in the treatment of pyloric obstruction.
Choice D rationale
The primary reason for the use of a nasogastric tube in the treatment of pyloric obstruction is to decompress the stomach. Pyloric obstruction can cause a buildup of gastric contents above the level of the obstruction, leading to symptoms such as nausea and vomiting. A nasogastric tube can be used to remove these contents and relieve symptoms.

Choice A rationale
An erythrocyte sedimentation rate (ESR) is a blood test that can detect and monitor inflammation in the body. It measures the rate at which red blood cells (erythrocytes) in a test tube separate from blood serum over time, with the rate being faster in people with inflammatory diseases. While it can be elevated in many conditions, including liver disease, it is not specific to liver disease and therefore would not typically be used to confirm a diagnosis of liver disease.
Choice B rationale
D-dimer is a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. It is typically used to rule out thrombosis (blood clots), not to diagnose liver disease.
Choice C rationale
C-reactive protein (CRP) is a protein made by the liver and sent into the bloodstream in response to inflammation. While it can be elevated in many conditions, including liver disease, it is not specific to liver disease and therefore would not typically be used to confirm a diagnosis of liver disease.

Choice D rationale
Albumin is a protein made by the liver, and measuring its levels can help diagnose liver disease. When the liver is damaged, it can’t make enough albumin, so the level of albumin in the blood gets lower. This is why albumin is often used as a marker of liver function, and why it would be anticipated in the laboratory values ordered to confirm a diagnosis of liver disease.
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