A registered nurse (RN) assesses a patient with cirrhosis and finds ascites with pitting edema of the feet and legs. Which factor contributes to edema and ascites in patients with cirrhosis?
Diminished serum albumin levels causes water to shift from blood to tissue.
Portal hypotension causes a fluid shift from the abdominal cavity into the portal veins.
Hypoaldosteronism causes a fluid volume deficit: shifting water from blood into tissue.
Aberrations of the portal system cause a back-up of blood that leads to hydronephrosis.
The Correct Answer is A
A. Diminished serum albumin levels cause water to shift from blood to tissue: In cirrhosis, liver dysfunction leads to decreased production of albumin, a protein that helps maintain oncotic pressure. Low albumin levels cause fluid to shift from the vascular space into the tissues, resulting in ascites and peripheral edema.
B. Portal hypotension causes a fluid shift from the abdominal cavity into the portal veins: Portal hypertension, not hypotension, is a common feature of cirrhosis, but it leads to ascites by increasing pressure in the portal venous system, not by shifting fluid into the portal veins.
C. Hypoaldosteronism causes a fluid volume deficit: shifting water from blood into tissue: Cirrhosis often leads to hyperaldosteronism, not hypoaldosteronism, resulting in sodium and water retention, which contributes to edema.
D. Aberrations of the portal system cause a back-up of blood that leads to hydronephrosis: Hydronephrosis is related to obstruction of the urinary tract, not a complication of portal hypertension or cirrhosis.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. High unconjugated, low direct: In liver disease, both conjugated (direct) and unconjugated bilirubin levels are typically elevated.
B. High conjugated, high direct: In cirrhosis and alcoholic liver disease, the liver's ability to process bilirubin is impaired, leading to elevated levels of both conjugated (direct) and unconjugated bilirubin, causing jaundice.
C. High direct, high unconjugated: Both direct (conjugated) and unconjugated bilirubin levels are elevated, but this does not clarify the direct relationship with jaundice.
D. Low indirect, normal unconjugated: In liver disease, bilirubin levels are elevated, not low or normal.
Correct Answer is C
Explanation
A. Tetany of the hands with a positive Chvostek sign: Tetany and a positive Chvostek sign are more associated with hypocalcemia rather than Hashimoto's thyroiditis.
B. Polyuria, sweating, and dry mucous membranes: These symptoms are more indicative of hyperthyroidism or diabetes rather than hypothyroidism, which is characteristic of Hashimoto's thyroiditis.
C. Forgetfulness, depression, and anemia: Hashimoto's thyroiditis, which causes hypothyroidism, can lead to symptoms like forgetfulness, depression, and anemia due to reduced thyroid hormone levels.
D. Nervousness, irritability, and diarrhea: These symptoms are associated with hyperthyroidism rather than hypothyroidism.
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