An older adult client is diagnosed with a severe urinary tract infection. The nurse assesses the client for which most serious complication?

Muscle weakness and motor seizures

Upper abdominal pain and cramping

Confusion and agitation

Periorbital edema and cardiac dysrhythmias

Answer and Explanation

The Correct Answer is C

Choice A reason: Muscle weakness and motor seizures are not the most serious complication because they are signs of electrolyte imbalance, not urinary tract infection. Electrolyte imbalance is a condition where the levels of minerals and salts in the blood are too high or too low, which can affect the nerve and muscle function, causing symptoms such as weakness, spasms, or seizures. Electrolyte imbalance can be caused by various factors, such as dehydration, kidney failure, or medications.

Choice B reason: Upper abdominal pain and cramping are not the most serious complication because they are signs of gastritis, not urinary tract infection. Gastritis is a condition where the lining of the stomach is inflamed, causing symptoms such as pain, nausea, or vomiting. Gastritis can be caused by various factors, such as infections, stress, or medications.

Choice C reason: Confusion and agitation are the most serious complication because they are signs of sepsis, which is a life-threatening condition where the body's response to an infection causes widespread inflammation and organ damage. Sepsis can be caused by various types of infections, including urinary tract infection, which is an infection that affects the bladder, urethra, or kidneys. Sepsis can cause symptoms such as confusion, agitation, fever, chills, or shock.

Choice D reason: Periorbital edema and cardiac dysrhythmias are not the most serious complication because they are signs of heart failure, not urinary tract infection. Heart failure is a condition where the heart cannot pump enough blood to meet the body's needs, causing symptoms such as swelling, shortness of breath, or irregular heartbeat. Heart failure can be caused by various factors, such as coronary artery disease, hypertension, or diabetes.

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Correct Answer is C

Explanation

Choice A reason: Initiates the fibrinolytic process in the arteries is not a role of inflammation in the development of atherosclerosis, but a protective mechanism against it. Fibrinolysis is the breakdown of blood clots by enzymes such as plasmin. It prevents the formation of thrombi that can occlude the arteries and cause ischemia.

Choice B reason: Decreases highly sensitive C-reactive protein (hsCRP) levels is not a role of inflammation in the development of atherosclerosis, but an indicator of it. hsCRP is a marker of systemic inflammation that is produced by the liver in response to cytokines. It is elevated in patients with atherosclerosis and correlates with the risk of cardiovascular events.

Choice C reason: Damages the endothelium of the arteries is the main role of inflammation in the development of atherosclerosis. Endothelial injury exposes the subendothelial layer to the blood, which triggers the adhesion of monocytes and platelets. Monocytes differentiate into macrophages and engulf oxidized low-density lipoproteins (LDL), forming foam cells. Foam cells accumulate in the intima and form fatty streaks, which are the earliest lesions of atherosclerosis.

Choice D reason: Causes diffuse arterial vasoconstriction is not a role of inflammation in the development of atherosclerosis, but a consequence of it. Atherosclerosis narrows the lumen of the arteries and reduces the blood flow to the tissues. This causes ischemia, which stimulates the release of vasoconstrictors such as angiotensin II and endothelin. Vasoconstriction further worsens the ischemia and increases the blood pressure.

A. Thrombosis of the small blood vessels in the substantia nigra. B. Increased acetylcholine levels and cholinergic activity in the brain. C. Cell-mediated immune response and muscle fiber damage. D. Increased production of dopamine in the motor cortex.

Correct Answer is A

Explanation

Choice A:
Thrombosis of the small blood vessels in the substantia nigra is the best explanation for the clinical manifestations observed in the patient. The substantia nigra is an area in the brain responsible for producing dopamine, a neurotransmitter involved in motor control. Thrombosis, or the formation of blood clots, in the small blood vessels of the substantia nigra can lead to a decrease in dopamine production, resulting in the symptoms of Parkinson's disease.

Choice B:
Increased acetylcholine levels and cholinergic activity in the brain are not the primary factors causing the manifestations of Parkinson's disease. In fact, Parkinson's disease is characterized by a decrease in dopamine levels, not an increase in acetylcholine.

Choice C:
Cell-mediated immune response and muscle fiber damage are not the main mechanisms underlying the clinical manifestations of Parkinson's disease. While inflammation and immune responses may play a role in the progression of the disease, they are not the primary cause of the symptoms observed.

Choice D:
Increased production of dopamine in the motor cortex is not the cause of the symptoms in Parkinson's disease. In fact, patients with Parkinson's disease experience a decrease in dopamine production due to the degeneration of dopamine-producing neurons in the substantia nigra.

Overall, the most plausible explanation for the patient's clinical manifestations is thrombosis of the small blood vessels in the substantia nigra, leading to a decrease in dopamine production.

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An older adult client is diagnosed with a severe urinary tract infection. The nurse assesses the client for which most serious complication?

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