The nurse is caring for a client with a history of liver cirrhosis. Which complication should the nurse monitor for?

Choice A reason: Increasing carbohydrate intake may prevent hypoglycemia but does not address the root cause, such as excessive insulin or oral hypoglycemic agents. Reviewing medications identifies dosing issues, ensuring safer management of type 2 diabetes, making it the priority over dietary changes.

Choice B reason: Reviewing the medication regimen is critical, as hypoglycemia in type 2 diabetes often results from excessive insulin or sulfonylureas. Adjusting doses or timing with a provider prevents recurrent episodes, addressing the primary cause and ensuring safe glycemic control, making it the priority action.

Choice C reason: Monitoring blood glucose hourly is reactive and impractical long-term. It confirms hypoglycemia but does not prevent it. Reviewing medications addresses the cause, such as inappropriate dosing, making it more effective for managing recurrent hypoglycemia in type 2 diabetes.

Choice D reason: High-protein snacks stabilize blood glucose but are secondary to addressing medication-related hypoglycemia. Excessive insulin or oral agents are likely causes, so reviewing the regimen is prioritized to correct dosing, preventing recurrent episodes more effectively than dietary adjustments alone.

Choice A reason: Limiting purine-rich foods (e.g., organ meats, shellfish) reduces uric acid production, preventing gout flares. Purines metabolize into uric acid, which forms joint crystals in gout. This dietary restriction is critical to manage symptoms and prevent painful exacerbations effectively.

Choice B reason: Increasing dairy may reduce gout risk by lowering uric acid, but it is secondary to purine restriction. Limiting purines directly decreases uric acid synthesis, addressing the primary cause of gout flares, making it the priority dietary recommendation.

Choice C reason: Restricting carbohydrates is irrelevant to gout, which results from uric acid accumulation. Purine-rich foods are the primary dietary trigger, as they increase uric acid. Limiting purines is the priority, as it directly prevents crystal formation and gout exacerbations.

Choice D reason: Encouraging red meat, high in purines, worsens gout by increasing uric acid production. Limiting purine-rich foods is critical, as it reduces uric acid and joint crystal formation, making red meat consumption counterproductive to effective gout management.