A client with a sudden onset of big toe joint pain and swelling is diagnosed with gout. Which pathophysiologic process is producing the symptoms of gout?

A) Elevation in blood pressure:

While elevation in blood pressure could potentially cause discomfort at the arterial line insertion site, it is not the most likely physiological effect to induce sudden pain in this scenario. Blood pressure elevation would typically cause generalized symptoms rather than localized pain at the insertion site.

B) Vasospasm at insertion site:

Correct. Vasospasm refers to the sudden constriction of blood vessels, leading to reduced blood flow. It can occur in response to arterial puncture or manipulation during arterial line insertion, resulting in sudden pain at the insertion site.

C) Clot in the arterial catheter:

A clot in the arterial catheter could potentially cause obstruction and affect blood flow, but it is less likely to induce sudden pain at the insertion site unless there is associated ischemia or tissue damage.

D) Air lock in the transducer:

An air lock in the transducer could disrupt pressure monitoring but is not typically associated with sudden pain at the insertion site. It may lead to inaccurate pressure readings rather than localized pain.

Hemodialysis is a renal replacement therapy used to remove waste products and excess fluid from the blood when the kidneys are unable to perform this function adequately. The physiological processes involved in hemodialysis include:

A) Solute movement toward a solution with a higher concentration:

While solute movement occurs during hemodialysis, it is typically from a solution with a higher concentration to one with a lower concentration, rather than the opposite. This movement facilitates the removal of waste products and excess solutes from the bloodstream.

B) Water movement toward a solution with a lower solute concentration:

Correct. Osmosis is the movement of water across a semipermeable membrane from an area of lower solute concentration to an area of higher solute concentration. In hemodialysis, water moves out of the bloodstream, across the semipermeable membrane of the dialyzer, and into the dialysate solution, which has a lower solute concentration. This process helps remove excess fluid from the body.

C) Blood cells and protein movement through the semipermeable membrane:

Blood cells and proteins are too large to pass through the pores of the semipermeable membrane in the dialyzer during hemodialysis. Therefore, the primary exchange occurs between smaller molecules such as urea, creatinine, electrolytes, and water.

D) Osmosis of water movement and diffusion of solute movement:

Correct. Hemodialysis involves both osmosis and diffusion. Osmosis refers to the movement of water across a semipermeable membrane from an area of lower solute concentration to an area of higher solute concentration. Diffusion is the movement of solutes from an area of higher concentration to an area of lower concentration. Together, these processes facilitate the removal of waste products and excess fluid from the bloodstream during hemodialysis.