A client with cirrhosis develops increasing abdominal girth, ankle edema, and dyspnea. What is the most likely complication?

Ascites is a common complication of cirrhosis caused by portal hypertension (increased pressure in the portal venous system due to liver fibrosis) combined with hypoalbuminemia (the liver can't produce enough albumin to maintain oncotic pressure). Fluid leaks into the peritoneal cavity. Signs: increased abdominal girth, weight gain, abdominal distention with shifting dullness on percussion, prominent abdominal veins (caput medusae), umbilical hernia, dyspnea if diaphragm is compromised. Management: (1) Sodium restriction (typically <2 g/day) — most important dietary intervention; (2) Diuretics — spironolactone first (potassium-sparing, addresses underlying hyperaldosteronism), often combined with furosemide; (3) Daily weight monitoring (same conditions); (4) Abdominal girth measurement; (5) Therapeutic paracentesis for symptomatic relief or refractory ascites (with albumin replacement after large-volume removal); (6) TIPS (transjugular intrahepatic portosystemic shunt) for refractory cases; (7) Liver transplant evaluation. Complications of ascites: spontaneous bacterial peritonitis (SBP — fever, abdominal pain, AMS — diagnosed by paracentesis with PMN >250), hepatorenal syndrome, umbilical hernia. Other cirrhosis complications: variceal bleeding, hepatic encephalopathy.