A client reports experiencing blurry central vision that has recently worsened. Which pathological process supports the client's subjective report?

Blockage of retinal capillaries causing ischemic damage of the central macular area.

Opaque spoke-like lines developing in the periphery of the lens to the center.

Tears in the retina that detach from the lining of the posterior eyeball.

An increase in intraocular pressure with loss of peripheral vision.

Answer and Explanation

The Correct Answer is A

A) Blockage of retinal capillaries causing ischemic damage of the central macular area:

Correct. Blurry central vision that worsens over time can be indicative of macular ischemia, often caused by blockage of retinal capillaries leading to ischemic damage of the central macular area. This condition can occur in diseases such as diabetic retinopathy or retinal vein occlusion.

B) Opaque spoke-like lines developing in the periphery of the lens to the center:

This description is more characteristic of cataracts, which cause visual disturbances such as glare or halos around lights rather than blurry central vision.

C) Tears in the retina that detach from the lining of the posterior eyeball:

Retinal tears and subsequent detachment can cause visual disturbances, but they typically present as sudden onset of floaters, flashes of light, and a curtain-like shadow over the visual field rather than blurry central vision.

D) An increase in intraocular pressure with loss of peripheral vision:

This description is indicative of glaucoma, which can lead to loss of peripheral vision (visual field defects) rather than blurry central vision. Glaucoma-related visual field loss usually begins peripherally and progresses inward, affecting central vision in later stages.

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Correct Answer is C

Explanation

A) Increased preload that results in generalized peripheral edema:

This statement is incorrect. Decreased blood volume due to hemorrhage leads to decreased preload, not increased preload. Generalized peripheral edema is more commonly associated with conditions such as heart failure or kidney disease, where fluid retention leads to increased preload.

B) The lowered blood pressure results in a reduction of the heart rate:

While it's true that a decrease in blood pressure can trigger compensatory mechanisms such as an increase in heart rate (tachycardia), the specific response mentioned in this option is not entirely accurate. The primary compensatory response to hemorrhage-induced hypotension is typically an increase in heart rate, not a reduction.

C) Decreased preload that can lead to decreased cardiac output:

Correct. With decreased blood volume (preload), there is less blood returning to the heart during diastole. This leads to decreased ventricular filling and subsequently decreased stroke volume and cardiac output. Decreased cardiac output can contribute to hypotension and inadequate tissue perfusion.

D) Increased peripheral resistance resulting from poor renal perfusion:

While poor renal perfusion can trigger mechanisms to increase peripheral resistance (such as activation of the renin-angiotensin-aldosterone system), this option does not directly address the primary effect of decreased preload on cardiac output. Increased peripheral resistance alone does not adequately compensate for decreased preload to maintain cardiac output.

A. Lipase. B. Myoglobinuria. C. White blood count (WBC). D. Bilirubin.

Correct Answer is A

Explanation

A) Lipase:

Correct. Lipase is an enzyme produced by the pancreas that aids in the digestion of fats. Elevated levels of lipase in the blood can indicate pancreatic damage or inflammation, such as that which may occur due to trauma like a gunshot wound to the abdomen. Pancreatic injury can lead to leakage of enzymes into the bloodstream, resulting in elevated serum lipase levels. Monitoring lipase levels helps assess pancreatic function and detect injury or disease.

B) Myoglobinuria:

Myoglobinuria refers to the presence of myoglobin, a protein found in muscle cells, in the urine. It is often associated with muscle injury or breakdown, such as rhabdomyolysis. While abdominal trauma may result in muscle injury, myoglobinuria is not specific to pancreatic damage and is more indicative of muscle-related injury or conditions.

C) White blood count (WBC):

Elevated white blood cell count (WBC), or leukocytosis, is a non-specific marker of inflammation or infection. While it may occur in response to tissue injury, including pancreatic injury, it is not specific to pancreatic damage and can be elevated due to various other factors, such as surgical stress, infection, or inflammation.

D) Bilirubin:

Bilirubin is a pigment produced during the breakdown of red blood cells and is excreted by the liver. Elevated levels of bilirubin may indicate liver dysfunction or obstruction of the bile ducts, but they are not specific to pancreatic damage. While pancreatic injury can lead to obstruction of the bile ducts in some cases, monitoring bilirubin levels alone is not sufficient to diagnose pancreatic damage.

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A client reports experiencing blurry central vision that has recently worsened. Which pathological process supports the client's subjective report?

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