Medical-surgical I

A patient with cirrhosis and known oesophageal varices is recovering from a chest infection and has been taught to cough vigorously and breathe deeply every hour. He also strains at stool most mornings and has been lifting sacks at work. Which of these facts should most change the nursing plan?

• AThe deep breathing, because it raises the pressure inside the chest
• BThe chest infection, because it will delay recovery of his liver
• CThe straining and the heavy lifting, because both spike the pressure in vessels that are already thin-walled and under strain
• DThe hourly frequency of the exercises, because a patient with liver disease tires quickly