Share This Link

A dry, hacking cough is a classic sign of left-sided heart failure, where blood backs up into the pulmonary circulation, causing pulmonary congestion and irritation of airway receptors. In isolated RV failure, pulmonary symptoms are usually minimal unless left-sided failure is also present (biventricular failure).

Crackles (rales) result from pulmonary edema, which is a hallmark of left-sided heart failure. In RV failure, the lungs are generally not congested, so crackles are not expected unless there is concomitant left ventricular dysfunction.

While dizziness can occur in any form of heart failure due to decreased cardiac output, it is nonspecific and is not considered a primary or hallmark sign of right-sided heart failure.

Calcitonin is a hormone produced by the parafollicular cells of the thyroid gland. Its primary role is to reduce elevated blood calcium levels by inhibiting osteoclast activity and increasing calcium excretion by the kidneys. While calcitonin influences calcium and phosphate balance, it has no significant function in regulating water reabsorption in the kidneys. Disorders affecting calcitonin levels do not cause abnormalities in fluid balance or urine concentration, which makes it unrelated to the physiologic mechanism of water conservation.

Aldosterone is a mineralocorticoid hormone released by the adrenal cortex. It acts on the distal tubules and collecting ducts of the kidney to increase sodium reabsorption and potassium excretion. Because water follows sodium osmotically, aldosterone can indirectly contribute to water retention. However, aldosterone does not directly change the kidney’s permeability to water. Water reabsorption in the presence of aldosterone still depends on antidiuretic hormone (ADH) to insert aquaporin channels into the renal tubules. Therefore, aldosterone cannot be considered the hormone responsible for water reabsorption itself; it influences sodium handling rather than direct water movement.

Atrial natriuretic peptide (ANP) is a hormone released by the atria of the heart when they are stretched due to increased blood volume. ANP has the opposite effect of hormones that promote fluid retention. It increases sodium and water excretion by dilating the afferent arteriole, increasing glomerular filtration rate, and inhibiting sodium reabsorption in the collecting ducts. It also antagonizes aldosterone and renin, promoting further loss of sodium and water. Because ANP enhances diuresis rather than water conservation, it does not play a physiological role in promoting water reabsorption. Instead, it helps reduce blood volume and blood pressure.

Purulent fluid is thick, opaque, and often yellow, green, or brown in color. It contains leukocytes, cellular debris, and bacteria, and is typically associated with infection. Because purulent fluid is not clear, it does not match the description provided by the client.

Hemorrhagic fluid contains blood. It appears red or dark red due to the presence of red blood cells and indicates bleeding into a wound or blister. Hemorrhagic fluid is not clear, so it does not correspond to the fluid described.

Serosanguineous fluid is a mixture of clear (serous) fluid and small amounts of blood, giving it a pale pink or light red appearance. While it is partially clear, the presence of blood changes its color, making it different from completely clear fluid.

Destruction of melanocytes occurs in conditions such as vitiligo, where the pigment-producing cells are lost, leading to depigmented patches. Psoriasis does not primarily affect melanocytes or pigmentation.

While secondary bacterial infections can occur in psoriatic lesions due to skin barrier disruption, bacterial overgrowth is not the underlying cause or pathophysiology of psoriasis.

Allergic reactions, such as contact dermatitis, involve hypersensitivity mechanisms, but psoriasis is not triggered by allergens in this manner.

Psoriasis is a chronic autoimmune-mediated skin disorder characterized by hyperproliferation of keratinocytes and inflammation. Clinically, it presents as well-demarcated, erythematous plaques covered with silvery-white scales, often found on extensor surfaces such as the elbows, knees, scalp, and lower back. Psoriatic lesions are typically not ring-shaped, nor do they have a clear center, so psoriasis does not match the client’s description.

Tinea capitis is a fungal infection caused primarily by dermatophytes affecting the scalp. It presents with scaling, hair loss, broken hairs, and sometimes pustules or kerion formation. Lesions occur on the scalp and hair-bearing areas, not usually on the arm, and the classic ring-shaped pattern with central clearing seen in tinea corporis is not characteristic of tinea capitis.

Eczema (atopic dermatitis) is a chronic inflammatory skin condition associated with impaired skin barrier function and immune dysregulation. It typically presents as pruritic, erythematous, and sometimes oozing patches. The lesions are often irregularly shaped, may be lichenified, and lack the ring-shaped configuration with central clearing. While eczema can affect the arms, the pattern described in the client does not align with classic eczema presentation.

Hypotension is not a typical finding during a vaso-occlusive crisis. Blood pressure may remain normal or be elevated due to pain and stress. Hypotension is more likely associated with severe anemia, hypovolemia, or septic complications rather than direct vaso-occlusion.

Bleeding gums suggest a bleeding or clotting disorder, such as thrombocytopenia or vitamin C deficiency, and are not characteristic of a vaso-occlusive crisis in sickle cell disease.

Bradycardia is not associated with vaso-occlusive crises. Heart rate may actually increase due to pain, stress, or anemia-related compensatory mechanisms.

Hypothalamus and pituitary are involved in autonomic and endocrine regulation, such as temperature control, hormone secretion, and homeostasis. While the hypothalamus can influence respiratory rate indirectly through stress or temperature changes, it does not serve as the primary control center for breathing.

Frontal cortex and occipital lobe are parts of the cerebral cortex responsible for voluntary movements, cognitive functions, and visual processing, respectively. While the frontal cortex can exert voluntary control over breathing (e.g., holding one’s breath), it is not the primary center responsible for automatic respiratory regulation.

Cerebellum and corpus callosum are involved in motor coordination, balance, and interhemispheric communication. They do not control the basic rhythmic pattern of respiration or respond directly to blood gas changes.

Recurrent urinary frequency may occur as a symptom of urinary tract obstruction or irritation, but it is a relatively minor and common manifestation. While uncomfortable for the client, urinary frequency itself is not the most serious or life-threatening complication of hydronephrosis.

Diabetic nephropathy is a form of chronic kidney disease caused by long-term diabetes mellitus. It is unrelated to hydronephrosis from urinary obstruction. While clients with diabetes may have an increased risk of kidney disease, diabetic nephropathy is not a direct complication of untreated kidney stones.

Orthostatic hypotension is a drop in blood pressure upon standing, often caused by dehydration, autonomic dysfunction, or certain medications. It is not a direct complication of hydronephrosis and is less clinically urgent than the risk of renal failure in this context.

Elevated serum calcium is not associated with PSGN. Calcium levels in the blood are primarily regulated by parathyroid hormone, vitamin D, and renal excretion of calcium. PSGN primarily affects glomerular filtration and fluid balance, not calcium metabolism. Any abnormalities in calcium would likely be incidental or due to other conditions, not a direct consequence of post-streptococcal glomerulonephritis.

Sudden onset of severe flank pain is more typical of renal calculi (kidney stones) or acute pyelonephritis. Kidney stones can obstruct urine flow, causing sharp, colicky flank pain radiating to the groin. Pyelonephritis, an infection of the renal pelvis, may cause flank pain accompanied by fever and urinary symptoms. PSGN, however, does not usually produce acute pain; its manifestations are primarily related to glomerular inflammation and fluid retention rather than obstruction or infection.

Excessive concentrated urine output and low blood pressure is inconsistent with PSGN. In PSGN, the glomerular injury reduces filtration, often causing oliguria (reduced urine output). Retained sodium and water contribute to fluid overload and hypertension rather than hypotension. Excessively concentrated urine is more characteristic of conditions with high antidiuretic hormone activity or dehydration, not post-infectious glomerulonephritis.

Burning during urination is most commonly associated with urinary tract infections (UTIs) or irritation of the urethra, not kidney stones. While stones can cause some urinary discomfort, dysuria alone is not the hallmark symptom for nephrolithiasis.

Dark, frothy urine with strong odor suggests proteinuria, hematuria, or a possible infection. These findings are more consistent with conditions like glomerulonephritis or urinary tract infections rather than kidney stones. Kidney stones do not typically produce frothy urine unless there is secondary infection or concurrent renal disease.

Dull flank pain relieved by rest is characteristic of musculoskeletal issues or chronic renal conditions but is not typical for kidney stones. Pain from kidney stones is usually acute and severe rather than dull and alleviated by rest.