A nurse is caring for a client who has kidney cancer and has been told it has metastasized. Which of the following statements should the nurse make when the client asks what metastasis means?

A. Ability to target and destroy CD4 lymphocytes: HIV targets and destroys CD4 lymphocytes, which are a key component of the immune system. This destruction weakens the immune system, making the individual more susceptible to opportunistic infections. This is a central feature of HIV's pathogenesis.
B. Conversion of the virus's RNA into DNA: The conversion of HIV's RNA into DNA occurs during replication, but this alone does not cause opportunistic infections. It is the destruction of CD4 cells that leads to the immune suppression and susceptibility to infections.
C. Having reverse transcriptase enzyme: Reverse transcriptase is an enzyme that helps HIV replicate its RNA into DNA. While essential for HIV replication, the presence of reverse transcriptase does not directly cause opportunistic infections; it is the result of the viral replication that weakens the immune system.
D. Containing only a single strand of genetic material: HIV contains single-stranded RNA as its genetic material. While this is true, the key factor in causing opportunistic infections is the virus’s ability to destroy CD4 cells, which weakens the immune system.

A. The kidneys continue to enlarge due to the cyst growing which increases the girth of your abdomen. Polycystic kidney disease is characterized by the progressive growth of fluid-filled cysts in the kidneys. These cysts cause the kidneys to enlarge significantly over time, which can lead to increased abdominal girth, a common finding in patients with advanced PKD.
B. The inflammation in your kidneys damages the filtration system which causes fluid retention in your abdomen. While PKD does impair kidney function, generalized fluid retention from decreased filtration more commonly leads to peripheral edema or hypertension, not isolated abdominal distension. Ascites is not typically associated with PKD unless there is concurrent liver involvement or severe renal failure.
C. The stones might descend into the ureters, blocking the flow of urine and causing an increase in the girth of your abdomen. Renal calculi can obstruct urine flow and cause hydronephrosis (kidney swelling), but they do not typically lead to noticeable abdominal distension. The increase in girth in PKD is more directly related to cystic kidney enlargement than to stone obstruction.
D. The kidney infection has caused narrowing of the ureters and your abdomen has filled with fluid.
Kidney infections can cause inflammation, but ureteral narrowing from infection is rare and would not cause significant abdominal girth increase. Additionally, abdominal fluid accumulation from infection would present with systemic signs like fever or peritonitis, which are not described here.