A patient is severely dehydrated from vomiting and diarrhea causing his or her blood to become hypertonic. What effects does the nurse expect this will have on the red blood cells
The blood cells will migrate to the bone marrow
the red cells will precipitate out of circulation
They will swell and eventually rupture
The cells will shrink and shrivel, decreasing their oxygen-carrying ability
The Correct Answer is D
A) The blood cells will migrate to the bone marrow:
While the bone marrow is responsible for producing red blood cells, dehydration and hypertonicity of the blood would not cause the red blood cells to migrate to the bone marrow. Migration of blood cells typically refers to white blood cells moving toward sites of infection or inflammation, not a response to dehydration.
B) The red cells will precipitate out of circulation:
Red blood cells do not precipitate out of circulation due to dehydration or hypertonic conditions. Instead, dehydration causes a shift in water balance that leads to changes in the shape and function of the red blood cells. Precipitation of cells is not a physiological response in this context.
C) They will swell and eventually rupture:
In conditions of hypertonicity, where the concentration of solutes (such as sodium) in the blood is higher than normal, red blood cells actually shrink, not swell. When blood is hypertonic, water moves out of the red blood cells into the extracellular space to balance the osmotic pressure, leading to cell shrinkage. Cells only swell in hypotonic conditions, when water moves into the cell.
D) The cells will shrink and shrivel, decreasing their oxygen-carrying ability:
When the body becomes dehydrated, the blood becomes hypertonic (more concentrated), leading to a shift of water out of the red blood cells to try to balance the osmotic gradient. As a result, the red blood cells shrink and shrivel. This shrinkage can impair their ability to carry oxygen effectively, as the cells may become more rigid and less flexible, making it difficult for them to navigate through small blood vessels and perform gas exchange in the lungs and tissues.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Risk for dehydration related to diarrhea:
Diarrhea is not a common issue directly associated with Parkinson’s disease or its typical treatments, such as dopaminergic medications. While some medications or conditions can cause gastrointestinal disturbances, dehydration due to diarrhea is not a primary concern in Parkinson’s disease.
B) Diarrhea related to dopaminergic effects:
Dopaminergic medications, such as levodopa, may cause gastrointestinal side effects, but diarrhea is not a primary or common side effect. Typically, dopaminergic effects can lead to constipation, not diarrhea.
C) Risk for injury related to CVS effects and incidence of orthostatic hypotension:
Parkinson's disease can cause autonomic dysfunction, which often leads to orthostatic hypotension increasing the risk of falls and injury. This is a valid and appropriate nursing diagnosis because patients with Parkinson’s disease often experience balance issues and dizziness due to this condition, making them more vulnerable to falls and injury.
D) Constipation related to dopaminergic effects:
While constipation is a common side effect of dopaminergic medications used to treat Parkinson's disease, the more appropriate diagnosis for a patient who has Parkinson’s disease would be one that addresses the immediate risks or complications related to mobility or autonomic dysfunction.
Correct Answer is D
Explanation
A) Reversal of bronchoconstriction: Narcotic antagonists are not used to reverse bronchoconstriction. Bronchoconstriction is typically managed with bronchodilators (such as beta-agonists) or corticosteroids. Narcotic antagonists, such as naloxone, specifically counteract the effects of opioids, not respiratory conditions like bronchoconstriction.
B) Reversal of tachycardia: Narcotic antagonists do not have an effect on reversing tachycardia. Tachycardia may result from various conditions, including stimulant use, dehydration, or heart conditions. Treatment for tachycardia typically involves addressing the underlying cause, such as using beta-blockers for cardiac issues, but not narcotic antagonists.
C) Treatment of alcohol dependence: While certain medications, like disulfiram or acamprosate, are used to treat alcohol dependence, narcotic antagonists are not typically indicated for alcohol dependence. Narcotic antagonists, such as naloxone, are primarily used for opioid overdose or dependence, not for alcohol use disorders.
D) Treatment of narcotic dependence: Narcotic antagonists, such as naloxone, are prescribed in the treatment of narcotic (opioid) dependence. These medications work by blocking the effects of opioids at the receptor sites, thereby preventing the "high" associated with opioid use. They are particularly useful in treating opioid overdoses and can also be used in the management of opioid addiction as part of a comprehensive treatment plan.
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