In a client with cirrhosis and elevated ammonia, which diet is anticipated?

• A. High-carbohydrate diet
• B. Low-protein diet
• C. Moderate-fat diet
• D. High-protein diet

Answer: (B)

Limiting protein intake is used to reduce ammonia production in hepatic encephalopathy associated with cirrhosis. Ammonia comes mainly from the breakdown of dietary protein by gut bacteria; a damaged liver can’t fully convert ammonia to urea, so it builds up and impairs brain function. By reducing dietary protein, you lower the nitrogen load entering circulation, helping to lower ammonia levels and lessen encephalopathy symptoms. At the same time, calories should come mainly from carbohydrates to spare protein for tissue maintenance and prevent malnutrition. As encephalopathy improves, protein can be safely increased to prevent malnutrition, with adjustments based on the patient’s response. Hence, the anticipated diet in this scenario is a low-protein diet.