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. Decreased respirations and CO2 retention: A thyrotoxic crisis (thyroid storm) typically involves increased, not decreased, respiratory rates and CO2 retention due to increased metabolic activity.
B. Seizures and extreme tachycardia: Thyrotoxic crisis is characterized by severe symptoms including extreme tachycardia, fever, and potentially seizures due to excessive thyroid hormone levels.
C. Constipation and a swollen abdomen: Constipation and abdominal swelling are more typical of hypothyroidism rather than a thyrotoxic crisis.
D. Hypotension and bradycardia: Thyrotoxic crisis usually causes tachycardia and hypertension rather than bradycardia and hypotension.
Correct Answer is D
Explanation
A. Several episodes of black and tarry stools: This indicates melena, which is typically associated with upper gastrointestinal bleeding, not specifically Crohn's disease.
B. Several episodes of hematochezia per day: Hematochezia (fresh blood in stools) can occur in Crohn's disease due to inflammation and ulceration in the intestines.
C. Post-alcohol ingestion epigastric pain: This is more commonly associated with gastritis or peptic ulcer disease, not Crohn's disease.
D. An oral temperature of 102°F: While fever can occur in Crohn's disease during acute flare-ups, it is not a specific or definitive symptom of the condition. The primary symptoms are gastrointestinal in nature, such as abdominal pain and altered bowel habits.
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