A client admitted five days ago with fatigue, confusion, nausea, and abdominal pain; long history of alcohol abuse; pancreatitis and liver failure. Lungs clear; liver palpable in LUQ. Since admission, the client has been NPO. The diet is to be advanced today. Which dietary choice is most appropriate?

• A. Low sodium
• B. High protein
• C. High fat
• D. High sugar

Answer: (A)

In liver failure, managing fluid balance is a primary concern when advancing a diet. Limiting sodium helps prevent fluid retention, edema, and ascites that accompany impaired hepatic function, making a low-sodium plan the most appropriate choice as the patient moves from NPO to nourishment.

A high-fat diet would be risky with a history of pancreatitis, and a high-sugar plan can worsen metabolic stress and glucose control. A high-protein plan doesn't address the fluid overload issue and, in the setting of liver failure with confusion, could complicate nitrogen balance and encephalopathy management. Therefore, restricting sodium best supports stabilization and safe progression of diet in this context.