What is a key sign of hepatic encephalopathy that a nurse should monitor in a client?

In hepatic encephalopathy, a key sign that a nurse should monitor is excessive sleepiness or drowsiness. This occurs due to the accumulation of toxins in the bloodstream, particularly ammonia, which affects brain function. As liver function deteriorates, the ability to filter these toxins diminishes, leading to altered mental status and neurological symptoms.

Excessive sleepiness can manifest as lethargy, confusion, or a decreased level of consciousness, which are critical indicators of the severity of the condition. Monitoring for these symptoms is crucial since they can progress to more severe complications, including coma.

The other signs mentioned do not align with the typical presentation of hepatic encephalopathy. For instance, increased appetite is not usually associated with this condition, as it tends to lead to a decreased desire to eat due to metabolic disturbances. Loss of balance and enhanced cognitive function are also not expected findings in hepatic encephalopathy, as the condition generally leads to cognitive impairment and coordination issues rather than improvement. Thus, recognizing excessive drowsiness is vital for timely intervention and management of the patient’s condition.