A nurse is assessing a patient with cirrhosis. The nurse should know that which of the following would indicate late stage liver deterioration?

Flapping tremor of the hands


• Hepatic deterioration, the later stages of cirrhosis, causes encephalopathy due to the increased levels of ammonia in the blood. This results in a diminished level of consciousness, confusion, flapping tremor of the hands (asterixis), and a sweet odor to the breath is often noted.

• Weight loss and muscle weakness occur long before the later stages of cirrhosis.

• Low urine output would be due to kidney deterioration.

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