A nurse is caring for a group of clients in a medical unit. Which of the following clients is at the highest risk for developing osmotic cerebral edema?
A client with a decreased potassium level
A client with a decreased serum glucose
A client with an increased hemoglobin A1C
A client with an increased creatinine level
The Correct Answer is B
Choice A Reason:
A client with a decreased potassium level is incorrect. Hypokalemia (decreased potassium level) can cause various neurological symptoms, but it doesn't directly lead to osmotic cerebral edema.
Choice B Reason:
When plasma glucose levels are rapidly lowered, an osmotic gradient develops between the brain and plasma, which can lead to cerebral edema. Brain cells pull water from the plasma, resulting in widespread edema.
Choice C Reason:
While HbA1c is an important marker of diabetes control and may indicate poor long-term management, it does not directly relate to the acute metabolic derangements (e.g., rapid osmotic shifts, severity of acidosis) that predispose to cerebral edema in DKA.
Choice D Reason:
A client with an increased creatinine level is incorrect. Elevated creatinine levels typically indicate kidney dysfunction or dehydration, but they don't directly cause osmotic cerebral edema.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Respiratory alkalosis is incorrect. Tension pneumothorax typically leads to respiratory distress and hypoxemia rather than respiratory alkalosis. The respiratory alkalosis may occur initially due to hyperventilation in response to hypoxemia but would not be directly related to tracheal deviation.
Choice B Reason:
Increased venous return is incorrect. Tension pneumothorax actually leads to decreased venous return due to compression of the great vessels in the thorax, particularly the superior vena cava and the inferior vena cava. This compression results from the increased pressure within the thorax, which impedes blood flow back to the heart.
Choice C Reason:
Decreased cardiac output is incorrect. Tension pneumothorax can indeed lead to decreased cardiac output due to compression of the heart and the great vessels by the accumulating air in the pleural space. This compression decreases venous return and impairs cardiac function.
Choice D Reason:
Dilated ventricles is incorrect. As mentioned earlier, tension pneumothorax can lead to compression of the heart, including the ventricles. This compression can cause dilatation of the ventricles, particularly the right ventricle, due to increased afterload and decreased venous return.
Correct Answer is ["A","B","D","E"]
Explanation
Choice A Reason:
Sexual intercourse is correct. Stimulation of the genitalia or other areas below the level of injury can trigger autonomic dysreflexia in individuals with spinal cord injuries.
Choice B Reason:
Tight clothing is correct. Any form of tight or restrictive clothing, including belts or waistbands, can stimulate the body below the level of injury and trigger autonomic dysreflexia.
Choice C Reason:
Nausea is incorrect. While nausea itself is not a common trigger for autonomic dysreflexia, it may occur as a result of the condition. Autonomic dysreflexia can cause a variety of symptoms, including nausea, due to the sudden increase in blood pressure.
Choice D Reason:
Surgery below the level of injury is correct. Surgical procedures performed below the level of the spinal cord injury can lead to stimulation of the body below the injury site, triggering autonomic dysreflexia.
Choice E Reason:
Urinary tract infections (UTIs) is correct. Infections of the urinary tract, especially those involving the bladder or urethra, can stimulate the body below the level of injury, leading to autonomic dysreflexia.
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