一位肝硬化病人發展出肝性腦病變（hepatic encephalopathy）。護理師應加強灌輸哪些飲食調整？
A client with cirrhosis of the liver develops hepatic encephalopathy. Which dietary modification should the nurse reinforce?
- ARestrict sodium intake to prevent ascites✓ 正解限制鈉攝取以預防腹水
- BLimit fluid intake to prevent fluid overload限制液體攝取以預防液體過載
- CIncrease protein intake to promote liver regeneration增加蛋白質攝取以促進肝臟再生
- DAdminister a high-fiber diet to improve bowel function給予高纖維飲食以改善腸道功能
肝性腦病變與肝臟無法有效代謝體內的氨（ammonia）有關，氨的累積會影響腦功能。雖然過去曾建議限制蛋白質，但現行準則認為適量蛋白質（特別是植物性或乳製品）對預防肌肉流失有益。限制鈉攝取（<2g/day）是預防和治療腹水（ascites）的關鍵，而腹水會加劇肝性腦病變的發生。
Hepatic encephalopathy is related to the liver's inability to effectively metabolize ammonia, the accumulation of which impairs brain function. Although protein restriction was previously recommended, current guidelines consider moderate protein intake (especially from plant or dairy sources) to be beneficial in preventing muscle wasting. Restricting sodium intake to less than 2 g/day is key to preventing and treating ascites, which itself can worsen hepatic encephalopathy.
美國營養師在肝病飲食指導上，較常使用專業評估工具，並與病人共同制定飲食計畫；台灣則可能由護理師或營養師獨立提供建議。