What is a common symptom expected in clients experiencing worsening hepatic encephalopathy?

• A. Disorientation and confusion.
• B. Increased energy levels.
• C. Decreased appetite.
• D. Severe fatigue.

Answer: (A)

Disorientation and confusion are hallmark symptoms of worsening hepatic encephalopathy. This condition occurs when liver function declines, leading to the accumulation of toxins, such as ammonia, in the bloodstream. As these toxins affect brain function, clients often exhibit confusion about their surroundings, difficulty concentrating, and changes in behavior. The neurological impairment can progress, leading to more severe symptoms such as asterixis (flapping hand tremors) and even coma in advanced cases.

The other symptoms, while they may arise in various situations or clinical conditions, do not specifically characterize hepatic encephalopathy in the same way that disorientation and confusion do. Increased energy levels are not typical, as these clients usually experience reduced energy and cognitive function due to toxin buildup. Decreased appetite and severe fatigue may accompany liver disease more broadly but are not as directly indicative of the acute changes in mental status that occur with hepatic encephalopathy.