The nurse assesses a client with cirrhosis and finds 4+ pitting edema of the feet and legs, and massive ascites. Which mechanism contributes to edema and ascites in clients with cirrhosis?
Hyperaldosteronism causing an increased sodium reabsorption in renal tubules.
Decreased renin-angiotensin response related to an increase in renal blood flow.
Decreased portacaval pressure with greater collateral circulation.
Hypoalbuminemia that results in a decreased colloidal oncotic pressure
The Correct Answer is D
A. Hyperaldosteronism causing an increased sodium reabsorption in renal tubules.
Hyperaldosteronism is characterized by an excess of aldosterone, a hormone that regulates sodium and water balance. In cirrhosis, however, sodium retention is often related to other mechanisms such as portal hypertension and hypoalbuminemia, rather than hyperaldosteronism.
B. Decreased renin-angiotensin response related to an increase in renal blood flow.
Cirrhosis is more commonly associated with an activated renin-angiotensin-aldosterone system, leading to increased sodium and water retention. The increased renin-angiotensin response is a compensatory mechanism to maintain perfusion in the setting of cirrhosis and does not contribute to decreased renal blood flow.
C. Decreased portacaval pressure with greater collateral circulation.
This statement is not accurate. In cirrhosis, there is typically increased portacaval pressure due to portal hypertension, which can lead to the development of collateral circulation. However, this does not explain the edema and ascites seen in cirrhosis.
D. Hypoalbuminemia that results in a decreased colloidal oncotic pressure.
This is the correct choice. In cirrhosis, liver damage leads to decreased synthesis of albumin. Albumin plays a crucial role in maintaining colloidal oncotic pressure, and when it is decreased (hypoalbuminemia), fluid is more likely to leak out of blood vessels, resulting in edema. The same mechanism contributes to the development of ascites in the abdominal cavity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Jogs more frequently than usual daily routine:
Exercise, including jogging, is generally not associated with an increased risk of renal calculi. In fact, regular physical activity can have health benefits.
B. Eats a vegetarian diet with cheese 2 to 3 times a day:
A vegetarian diet alone is not necessarily a risk factor for renal calculi. However, the inclusion of high-oxalate foods, such as certain types of cheese, may contribute to the formation of kidney stones.
C. Experiences additional stress since adopting a child:
Stress is not a direct risk factor for renal calculi. However, certain dietary and lifestyle factors play a more significant role in stone formation.
D. Drinks several bottles of carbonated water daily:
This is the correct answer. Consuming large amounts of carbonated water, especially if it is high in phosphoric acid, can contribute to the formation of kidney stones. Carbonated beverages may increase the excretion of calcium in the urine, potentially leading to stone formation.
Correct Answer is B
Explanation
A. Jugular vein distention:
Jugular vein distention is not typically associated with an increased risk of a stroke. It may be indicative of issues related to cardiac or fluid volume status.
B. Carotid bruit:
This is the correct answer. A carotid bruit, an abnormal sound caused by turbulent blood flow through the carotid artery, may indicate the presence of atherosclerosis and increased risk of stroke. It suggests a narrowing or blockage in the carotid artery, which can potentially lead to emboli and subsequent stroke.
C. Nuchal rigidity:
Nuchal rigidity, stiffness of the neck, is associated with conditions such as meningitis but is not a direct risk factor for a stroke.
D. Palpable cervical lymph node:
Palpable cervical lymph nodes may be indicative of infection or inflammation in the head and neck region but are not directly associated with an increased risk of a stroke.
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