Practice Question
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?
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Correct Answer:
Hypoalbuminemia that results in a decreased colloidal oncotic pressure.
Rationale:
🌟 In cirrhosis, the damaged liver has reduced ability to synthesize albumin, the main plasma protein responsible for maintaining colloidal oncotic pressure in the vascular system.
🌟 Hypoalbuminemia leads to fluid shifting out of the intravascular space into the interstitial tissues and peritoneal cavity, causing peripheral edema and ascites.
🌟 Ascites is further aggravated by portal hypertension and activation of the renin-angiotensin-aldosterone system (RAAS), but the primary mechanism behind massive fluid accumulation is the loss of oncotic pressure due to low albumin.
🌟 Without enough albumin, the vascular system cannot "hold" fluid, so it leaks into dependent tissues (legs, feet) and the abdominal cavity.
🌟 Correcting hypoalbuminemia (e.g., through nutrition, albumin infusions, or managing underlying liver disease) is key to controlling ascites and edema.
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This question is from HESI RN Med-Surg Fall 2024. which contains 40 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: HESI Exam(s)
- Domain: Hesi MedSurg
- Answer Choices: 4