How should the nurse assess for asterixis in a client with cirrhosis?

Asterixis is a type of tremor characterized by a sudden, brief loss of muscle tone that causes an intermittent flapping motion of the hands. It is often associated with metabolic disturbances such as hepatic encephalopathy, commonly seen in clients with liver conditions like cirrhosis.

To assess for asterixis, the most effective method is to have the client extend their arms and fully flex their wrists. This position allows for the observation of any characteristic flapping movements that may occur as the muscles fail to maintain control due to the underlying neurological dysfunction associated with liver impairment. When the client's arms are extended, you can easily see if there are any purposeless movements, which would indicate asterixis.

The other options involve assessments that do not specifically evaluate for the characteristic tremors associated with asterixis. For example, measuring abdominal girth or dorsiflexing the foot are not related to assessing for this particular type of movement disorder. Leaning forward might also not give a reliable indication of asterixis. Therefore, extending the arms provides the necessary position to identify this tremor effectively.