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 reason : Encouraging avoidance of anxiety-increasing situations may seem beneficial, but it can reinforce OCD behaviors. Avoidance prevents the client from learning how to cope with anxiety and can limit their ability to participate in daily activities⁴.

Choice B reason : Investigating what situations precipitate anxiety is a crucial step in managing OCD. Understanding the specific triggers can help in developing strategies to cope with and eventually reduce the anxiety associated with these situations. This approach is aligned with cognitive-behavioral therapy principles, which are effective in treating OCD⁴⁵.

Choice C reason : Teaching the client that compulsive behavior is excessive is part of psychoeducation. However, simply telling a client that their behavior is excessive without providing coping mechanisms can be unhelpful and may increase their anxiety. It's important to combine this with therapeutic techniques that help the client manage their compulsions⁴.

Choice D reason : Preventing the client from performing compulsive behavior abruptly can cause significant distress and may not be feasible or safe. Instead, treatment usually involves gradual exposure to anxiety-provoking situations and learning to resist the urge to perform compulsions, a technique known as exposure and response prevention (ERP)⁴.

Choice A reason : Achieving a blood pressure of 120/80 is a general goal for overall cardiovascular health, but it is not specific to the management of heart failure. While controlling blood pressure is important in heart failure, the primary objective is to reduce the heart's workload¹.

Choice B reason : Reducing the workload on the heart is a key objective in managing heart failure. This can be achieved through medications that improve heart function, lifestyle changes, and sometimes surgical interventions. The goal is to improve the heart's efficiency and reduce symptoms such as shortness of breath and fatigue¹.

Choice C reason : Encouraging the client to walk briskly on a treadmill at 4 to 5 miles an hour may not be appropriate for all heart failure patients, especially without medical supervision. Exercise recommendations should be personalized based on the individual's condition and tolerance¹.

Choice D reason : While dietary modifications are part of heart failure management, completely eliminating all sodium and fat is not practical or recommended. Instead, a balanced diet with controlled sodium intake is advised to help manage fluid retention¹.