The nurse provides care for a client diagnosed with non-Hodgkin lymphoma. Which observation does the nurse expect to find during assessment of the client?

Choice A reason: Formation of a clot in the middle cerebral artery is not the most likely cause of death because it is a condition that affects the brain, not the heart. A clot in the middle cerebral artery can cause a stroke, which is a sudden interruption of blood flow to the brain, resulting in brain damage and neurological deficits. A stroke can be fatal, but it does not usually cause cardiopulmonary arrest, which is a sudden cessation of heart and lung function.

Choice B reason: Obstruction of left ventricular blood flow and cardiac dysrhythmias is the most likely cause of death because it is a condition that affects the heart, which is the organ responsible for pumping blood throughout the body. Obstruction of left ventricular blood flow can be caused by hypertrophic cardiomyopathy, which is a genetic disorder that causes the heart muscle to become abnormally thick and stiff, reducing the amount of blood that the heart can pump. Cardiac dysrhythmias are abnormal heart rhythms that can interfere with the electrical signals that control the heart's contractions. Both conditions can lead to sudden cardiac death, which is a sudden and unexpected loss of heart function, resulting in cardiopulmonary arrest.

Choice C reason: Fluid volume overload and decreased serum potassium levels are not the most likely cause of death because they are conditions that affect the fluid and electrolyte balance of the body, not the heart. Fluid volume overload is a condition where the body retains too much fluid, which can cause edema, hypertension, and heart failure. Decreased serum potassium levels are a condition where the blood has too little potassium, which is an electrolyte that helps regulate the nerve and muscle function, including the heart. Both conditions can affect the heart function, but they are not usually the direct cause of cardiopulmonary arrest.

Choice D reason: Diffuse atherosclerosis in the left main coronary artery circulation is not the most likely cause of death because it is a condition that affects the blood vessels, not the heart. Atherosclerosis is a disease that causes the buildup of plaque, which is a fatty substance, in the walls of the arteries, which are the blood vessels that carry oxygen-rich blood to the organs. Diffuse atherosclerosis in the left main coronary artery circulation means that the plaque affects the entire length of the artery that supplies blood to the left side of the heart, which is the side that pumps blood to the rest of the body. Atherosclerosis can cause coronary artery disease, which is a condition where the heart does not receive enough blood and oxygen, leading to chest pain, angina, or heart attack. A heart attack can cause cardiopulmonary arrest, but it is not as common as sudden cardiac death in young adults.

Choice A reason: Blood flow is diverted from the abdominal muscles to the liver due to increased intravascular pressure is not the best description because it is a condition that affects the distribution of blood in the body, not the accumulation of fluid in the abdomen. Intravascular pressure is the pressure exerted by the blood on the walls of the blood vessels, which can be affected by various factors, such as blood volume, cardiac output, or vascular resistance. Increased intravascular pressure can cause blood flow to be diverted from the peripheral areas, such as the abdominal muscles, to the central areas, such as the liver, which can result in symptoms such as portal hypertension, which is a high blood pressure in the vein that carries blood from the digestive organs to the liver.

Choice B reason: Vasodilation of the mesenteric blood vessels promotes movement of sodium into the peritoneum is not the best description because it is a condition that affects the diameter of the blood vessels in the abdomen, not the accumulation of fluid in the abdomen. Vasodilation is the widening of the blood vessels, which can be caused by various factors, such as nitric oxide, prostaglandins, or histamine. Vasodilation of the mesenteric blood vessels, which are the blood vessels that supply the intestines, can increase the blood flow and the permeability of the capillaries, which are the smallest blood vessels, allowing sodium and water to move from the blood to the peritoneum, which is the membrane that covers the abdominal organs and the abdominal wall. However, this is not the main mechanism for ascites development in this client, because the amount of sodium and water that moves through the capillaries is normally balanced by the lymphatic system, which is a network of vessels that drains the excess fluid and returns it to the blood.

Choice C reason: Fluid moves from the intravascular space to the interstitial space due to decreased serum albumin levels is the best description because it is a condition that affects the osmotic pressure of the blood, which is the main mechanism for ascites development in this client. Osmotic pressure is the pressure that is exerted by the solutes, such as proteins, in a solution, which determines the movement of water across a semipermeable membrane, such as the capillary wall. Albumin is the most abundant protein in the blood, which is produced by the liver and helps to maintain the osmotic pressure of the blood. Decreased serum albumin levels can be caused by various factors, such as liver failure, malnutrition, or inflammation. Decreased serum albumin levels can reduce the osmotic pressure of the blood, which means that the blood cannot retain enough water, causing fluid to move from the intravascular space, which is the space within the blood vessels, to the interstitial space, which is the space between the cells and the blood vessels. This can result in edema, which is the swelling of the tissues due to fluid accumulation, especially in the abdomen, which is called ascites.

Choice D reason: The liver metabolizes increased amounts of antidiuretic hormone and aldosterone is not the best description because it is a condition that affects the hormonal regulation of water and sodium balance, not the accumulation of fluid in the abdomen. Antidiuretic hormone and aldosterone are hormones that help the kidneys retain water and sodium, respectively, and regulate the fluid and electrolyte balance in the body. Antidiuretic hormone is produced by the hypothalamus and secreted by the pituitary gland, while aldosterone is produced by the adrenal glands. The liver is involved in the metabolism and clearance of these hormones, which means that it breaks them down and removes them from the blood. Increased amounts of antidiuretic hormone and aldosterone can be caused by various factors, such as dehydration, heart failure, or renal failure. Increased amounts of antidiuretic hormone and aldosterone can cause the kidneys to reabsorb more water and sodium, which can increase the blood volume and the blood pressure, but this is not the main mechanism for ascites development in this client, because the fluid that accumulates in the abdomen is not from the kidneys, but from the capillaries.