Identify two causes of ascites related to liver cirrhosis:
Poor nutrition related to alcoholism results in abdominal obesity.
Portal hypertension pushes proteins from the blood vessels, causing leakage into the peritoneal cavity.
Osmoreceptors in the hypothalamus stimulate thirst, which causes the patient to take in excessive fluids orally.
There is decreased colloid oncotic pressure from the liver's inability to synthesize albumin.
Correct Answer : B,D
Choice A reason: Poor nutrition related to alcoholism can lead to abdominal obesity, but it is not a direct cause of ascites in liver cirrhosis. Ascites is primarily due to factors like portal hypertension and decreased colloid oncotic pressure.
Choice B reason: Portal hypertension is a significant cause of ascites in liver cirrhosis. The increased pressure in the portal vein causes proteins to leak from the blood vessels into the peritoneal cavity, leading to fluid accumulation.
Choice C reason: Osmoreceptors in the hypothalamus stimulating thirst can lead to excessive fluid intake, but this is not a direct cause of ascites related to liver cirrhosis. Ascites is more directly linked to portal hypertension and decreased colloid oncotic pressure.
Choice D reason: Decreased colloid oncotic pressure due to the liver's inability to synthesize albumin is a key factor in the development of ascites. Albumin helps maintain fluid balance in the blood vessels, and its deficiency leads to fluid leakage into the peritoneal cavity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: 0.45% sodium chloride is a hypotonic solution, which is not ideal for rapidly replacing fluid volume in patients with low blood pressure due to severe diarrhea. Hypotonic solutions can cause fluid to move into cells rather than staying in the vascular space, potentially worsening hypotension.
Choice B reason: 0.9% sodium chloride, also known as normal saline, is an isotonic solution. It is the best choice for rapidly replacing fluid volume in patients with low blood pressure. Isotonic solutions stay in the vascular space and help restore circulating blood volume and blood pressure without causing fluid shifts that can lead to cellular edema or dehydration.
Choice C reason: 5% dextrose in 0.9% sodium chloride is a hypertonic solution, which might not be the most appropriate for initial rapid fluid resuscitation. Hypertonic solutions can draw fluid into the vascular space from the interstitial and intracellular spaces, potentially leading to rapid changes in fluid balance and electrolyte shifts.
Choice D reason: 5% dextrose in 0.45% sodium chloride is also a hypertonic solution but with a hypotonic component (0.45% sodium chloride). This combination is not typically used for rapid fluid resuscitation because it can cause fluid shifts that are less predictable and may complicate the patient's electrolyte balance and hydration status.
Correct Answer is A
Explanation
Choice A reason: A blood pressure of 128/76 mm Hg is within the target range for a patient with hypertension, indicating that the current therapy is effectively managing the condition. This reading is below the generally accepted threshold for hypertension, which is 140/90 mm Hg.
Choice B reason: A blood pressure of 148/78 mm Hg is above the target range for hypertension management. This reading suggests that the patient may need an adjustment in their therapy to better control their blood pressure and reduce the risk of cardiovascular complications.
Choice C reason: A blood pressure of 98/56 mm Hg is too low and may indicate hypotension, which can be a concern, especially if the patient experiences symptoms like dizziness or fainting. This reading suggests that the patient's therapy may need to be adjusted to avoid excessively lowering blood pressure.
Choice D reason: A blood pressure of 128/92 mm Hg shows an elevated diastolic pressure, which is above the target range. This indicates that the patient's hypertension is not fully controlled, and adjustments in therapy may be needed to bring both systolic and diastolic pressures within the desired range.
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