An older client with cirrhosis on diuretic therapy shows a steady weight loss. Which of the following findings most likely indicates effective diuresis?

• A. Decreased serum potassium
• B. Increased edema
• C. Weight loss of 2.2 lb (1 kg) in 24 hours
• D. Elevated blood pressure

Answer: (C)

The key idea is that effective diuresis in cirrhosis is reflected by a reduction in excess body fluid, which shows up as weight loss. When diuretics remove fluid from the body, the scale will steadily drop as about the amount of fluid lost is excreted. A weight reduction of roughly 1 liter (about 1 kg or 2.2 pounds) in 24 hours is a practical and commonly used indicator that diuresis is occurring and excess fluid is being mobilized.

Other changes aren’t as direct a signal of diuretic effectiveness. A drop in potassium can happen with some diuretics but isn’t a reliable measure of fluid removal and varies with the specific agents used. Increased edema would mean fluid retention is worsening, not being diuresed. Elevated blood pressure is not a direct marker of diuresis and can occur for reasons unrelated to fluid loss, whereas the most immediate sign of successful fluid removal is the expected weight loss.