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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Decreased blood pressure:
Isoproterenol (Isuprel) is a non-selective beta-adrenergic agonist that primarily stimulates beta-1 and beta-2 receptors. It causes vasodilation through beta-2 stimulation, but its predominant effect is increasing heart rate and cardiac output via beta-1 stimulation. This tends to result in an increase in blood pressure
B) Decreased heart rate:
Isoproterenol generally leads to an increase in heart rate because of its beta-1 adrenergic activity, which stimulates the heart's pacemaker cells. It is commonly used to treat bradycardia (slow heart rate).
C) Increased body temperature:
Although isoproterenol can lead to increased heart rate and blood flow, it does not directly cause a significant increase in body temperature. Temperature changes are more commonly seen with drugs affecting metabolism or those that induce fever.
D) Increased blood pressure:
Isoproterenol stimulates beta-1 receptors in the heart, leading to increased heart rate and cardiac output, which typically results in an increase in blood pressure. However, due to its beta-2 effects, there can be some vasodilation, which may counteract this effect slightly. Despite this, the overall effect of isoproterenol is typically an increase in blood pressure, especially in a shock setting, where improving circulation is critical.
Correct Answer is B
Explanation
A) Irritable bowel disease: Benztropine is an anticholinergic medication that can reduce gastrointestinal motility, which might exacerbate constipation. However, irritable bowel disease (IBD) is not a contraindication for using benztropine. The drug is more likely to cause concern in conditions where smooth muscle relaxation could worsen symptoms of constipation, but it is not typically withheld due to IBD alone.
B) Glaucoma: Glaucoma, particularly narrow-angle glaucoma, is a contraindication for benztropine use. Benztropine, as an anticholinergic agent, can cause pupil dilation (mydriasis), which can increase intraocular pressure and worsen glaucoma. This is a critical concern for patients with glaucoma, and the healthcare provider should be notified before administering the drug.
C) Asthma: While benztropine can have mild anticholinergic effects that may cause dryness of the respiratory tract, it is not a contraindication for asthma. Beta-agonist inhalers are more commonly prescribed to manage bronchospasm, but the use of benztropine in asthma is not typically harmful unless the patient is experiencing severe respiratory distress. Asthma would not be a primary concern when administering this medication.
D) Hypertension: Benztropine does not directly affect blood pressure in a way that would be a concern for someone with hypertension. While it may cause some mild autonomic changes (like dry mouth or dizziness), hypertension is not a contraindication for the medication. Therefore, there is no specific need to notify the healthcare provider due to a history of hypertension.
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