The nurse is caring for an older client who is on complete bed rest. The nurse notes hematuria when the client suddenly reports excruciating pain that radiates from the back to the groin. Which pathological process has contributed to the client's clinical presentation of a possible renal calculi?

A. Chronic kidney disease:

Chronic kidney disease (CKD) is a complication of diabetes mellitus (DM), but it typically develops over time due to long-standing hyperglycemia and its effects on the kidneys. While CKD can lead to various complications such as electrolyte imbalances and cardiovascular disease, it is not directly associated with the development of gangrenous toes.

B. Diabetic retinopathy:

Diabetic retinopathy is a complication of diabetes that affects the eyes, specifically the retina. It results from damage to the blood vessels in the retina due to prolonged hyperglycemia. While diabetic retinopathy can lead to vision impairment and blindness if left untreated, it is not directly associated with the development of gangrenous toes.

C. Peripheral neuropathy:

Peripheral neuropathy is a common complication of diabetes that results from damage to the peripheral nerves due to prolonged hyperglycemia. It can lead to sensory, motor, and autonomic nerve dysfunction. Peripheral neuropathy contributes to the development of complications such as diabetic foot ulcers and Charcot arthropathy, which can ultimately lead to gangrene if not properly managed.

D. Hypertension:

Hypertension, or high blood pressure, is a common comorbidity in individuals with diabetes mellitus. While hypertension can exacerbate complications such as diabetic nephropathy and cardiovascular disease, it is not directly associated with the development of gangrenous toes.

Leukotrienes are inflammatory mediators derived from arachidonic acid metabolism, primarily produced by leukocytes (white blood cells) such as mast cells, eosinophils, and basophils. In the context of asthma, leukotrienes play a significant role in the pathophysiology of the disease by contributing to airway inflammation and bronchoconstriction. Here's a breakdown of their immune response:

A) Produce the sensation of itching:

Leukotrienes are not directly involved in producing the sensation of itching. Itching is often associated with histamine release rather than leukotrienes.

B) Tighten airway and produce mucous:

Correct. Leukotrienes are potent bronchoconstrictors that cause smooth muscle contraction in the airways, leading to narrowing (constriction) of the bronchioles. Additionally, they stimulate the secretion of mucus from goblet cells in the airway epithelium, contributing to airway obstruction and mucus production, which are characteristic features of asthma exacerbations.

C) Causes formation of bradykinin:

Bradykinin is a peptide mediator that is generated from the plasma protein kininogen and is involved in vasodilation, pain sensation, and inflammation. Leukotrienes are not directly responsible for the formation of bradykinin.

D) Serves as a receptor for antigen:

Leukotrienes do not serve as receptors for antigens. Instead, they are lipid mediators released in response to various stimuli, including allergens, infections, and irritants, and they act on specific receptors (e.g., leukotriene receptors) to exert their effects, such as bronchoconstriction and inflammation