A nurse is caring for a client admitted with meningitis. The student nurse asks, "I know that the client has a lot of edemas in the brain, but what causes it?" Which of the following responses from the nurse best answers the student's question?

"Cerebral edema is caused by osmotic cerebral edema."

"Cerebral edema is caused by whole body inflammation which affects the brain the most."

"Cerebral edema is caused by the by-products of the pathogen that causes the meningitis."

"Cerebral edema is caused by cerebrospinal fluid flowing from the intraventricular space to the interstitial area of the brain."

Answer and Explanation

The Correct Answer is C

A. Osmotic edema refers to fluid shifts due to changes in osmotic gradients (as seen in conditions like hyponatremia), not the inflammatory process of meningitis.

B. While inflammation is a key part of the body's response in meningitis, the edema is not a result of generalized whole-body inflammation. The edema is more directly linked to local inflammatory reactions in the brain triggered by the pathogen’s by-products.

C. Bacterial cell walls, endotoxins, and other components released by the bacteria directly stimulate inflammation, causing the breakdown of the BBB and allowing fluid and inflammatory cells to leak into the brain tissue.

D. This description is more aligned with the pathophysiology of conditions like hydrocephalus rather than meningitis. In meningitis, cerebral edema is primarily due to the inflammatory response, not abnormal CSF flow.

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Correct Answer is A

Explanation

Choice A Reason:

Vasogenic cerebral edema is appropriate response. Vasogenic cerebral edema occurs due to disruption of the blood-brain barrier (BBB), leading to leakage of fluid and proteins from the blood vessels into the brain parenchyma. This type of cerebral edema is commonly associated with conditions such as brain tumors, abscesses, and ischemic stroke.

Choice B Reason:

Osmotic cerebral edema is inappropriate response. Osmotic cerebral edema occurs when there is an imbalance of osmotic forces across the blood-brain barrier, leading to the movement of water into the brain cells. This type of cerebral edema can result from conditions such as hyponatremia or the administration of hypertonic solutions.

Choice C Reason:

Cellular cerebral edema is inappropriate response. Cellular cerebral edema involves the swelling of brain cells (neurons and glial cells) due to various insults, such as ischemia, hypoxia, or metabolic disturbances. This type of cerebral edema can occur in conditions such as ischemic stroke or traumatic brain injury.

Choice D Reason:

Interstitial cerebral edema is incorrect response. Interstitial cerebral edema involves the accumulation of fluid within the interstitial spaces of the brain tissue. This type of cerebral edema can occur in conditions such as hydrocephalus, where there is obstruction of cerebrospinal fluid (CSF) flow.

A. Hyponatremia B. Paresthesia C. Foot drop D. Intermittent pain Hyperreflexia

Correct Answer is ["B","C","D"]

Explanation

Choice A Reason:

Hyponatremia is incorrect. Hyponatremia refers to low sodium levels in the blood and is not typically associated with degenerative disc disease. This finding is unrelated to the pathophysiology of DDD.

Choice B Reason:

Paresthesia is correct. Yes, paresthesia, which refers to abnormal sensations such as tingling, numbness, or burning, can develop with degenerative disc disease. Nerve compression or irritation due to disc degeneration can lead to paresthesia in the affected area, typically radiating along the nerve pathway.

Choice B Reason:

Foot drop is correct. Yes, foot drop can develop with degenerative disc disease, especially if the condition leads to nerve compression or damage in the lumbar spine (lower back). Foot drop refers to difficulty lifting the front part of the foot due to weakness or paralysis of the muscles involved in dorsiflexion.

Choice D Reason:

Intermittent pain is correct. Yes, intermittent pain is a hallmark symptom of degenerative disc disease. Pain may vary in intensity and may worsen with certain movements or activities. Individuals with DDD may experience episodes of acute pain, as well as chronic, persistent discomfort.

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A nurse is caring for a client admitted with meningitis. The student nurse asks, "I know that the client has a lot of edemas in the brain, but what causes it?" Which of the following responses from the nurse best answers the student's question?

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