A client develops edema of the left arm and hand following a left radical mastectomy. The nurse explains the cause of the edema. Which explanation is correct?

Lymph structures were removed and fluid cannot move out of the area easily.

There is still too much swelling in the area of the surgery and fluid is accumulating.

The veins were removed from the axilla during surgery and there is poor circulation now.

You will need to wear a compression bandage to help fluids move from the area.

Answer and Explanation

The Correct Answer is A

Choice A reason: Lymph structures were removed and fluid cannot move out of the area easily is the correct explanation because a radical mastectomy involves the removal of the breast, the underlying chest muscles, and the lymph nodes in the axilla. The lymph nodes are part of the lymphatic system, which is responsible for draining excess fluid from the tissues and returning it to the bloodstream. When the lymph nodes are removed, the fluid cannot be drained properly and accumulates in the affected arm and hand, causing edema.

Choice B reason: There is still too much swelling in the area of the surgery and fluid is accumulating is not the correct explanation because it does not address the underlying cause of the edema. Swelling is a normal response to surgery, but it usually subsides within a few days or weeks. The edema caused by lymph node removal is chronic and persistent, and it does not improve with time.

Choice C reason: The veins were removed from the axilla during surgery and there is poor circulation now is not the correct explanation because it is not true. The veins are not removed during a radical mastectomy, only the lymph nodes are. The veins are part of the circulatory system, which carries blood throughout the body. The blood flow to the arm and hand is not affected by the surgery, unless there is a complication such as a blood clot or an infection.

Choice D reason: You will need to wear a compression bandage to help fluids move from the area is not the correct explanation because it is a treatment, not a cause. A compression bandage is a type of elastic bandage that applies pressure to the arm and hand, which helps to reduce the swelling and prevent further fluid accumulation. However, it does not address the root cause of the edema, which is the removal of the lymph nodes.

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Correct Answer is A

Explanation

Choice A:
Thrombosis of the small blood vessels in the substantia nigra is the best explanation for the clinical manifestations observed in the patient. The substantia nigra is an area in the brain responsible for producing dopamine, a neurotransmitter involved in motor control. Thrombosis, or the formation of blood clots, in the small blood vessels of the substantia nigra can lead to a decrease in dopamine production, resulting in the symptoms of Parkinson's disease.

Choice B:
Increased acetylcholine levels and cholinergic activity in the brain are not the primary factors causing the manifestations of Parkinson's disease. In fact, Parkinson's disease is characterized by a decrease in dopamine levels, not an increase in acetylcholine.

Choice C:
Cell-mediated immune response and muscle fiber damage are not the main mechanisms underlying the clinical manifestations of Parkinson's disease. While inflammation and immune responses may play a role in the progression of the disease, they are not the primary cause of the symptoms observed.

Choice D:
Increased production of dopamine in the motor cortex is not the cause of the symptoms in Parkinson's disease. In fact, patients with Parkinson's disease experience a decrease in dopamine production due to the degeneration of dopamine-producing neurons in the substantia nigra.

Overall, the most plausible explanation for the patient's clinical manifestations is thrombosis of the small blood vessels in the substantia nigra, leading to a decrease in dopamine production.

A. Glomerulonephritis B. Fluid volume deficit C. Neurogenic bladder D. Renal calculus

Correct Answer is B

Explanation

Choice A reason: Glomerulonephritis is an inflammation of the glomeruli, the filtering units of the kidneys. It can cause damage to the renal tissue and lead to intrinsic acute kidney injury, not prerenal acute kidney injury.

Choice B reason: Fluid volume deficit is a condition in which the body loses more fluid than it takes in. It can cause hypovolemia, which reduces the blood flow to the kidneys and impairs their function. This is the most common cause of prerenal acute kidney injury, which is a result of decreased perfusion to the kidneys.

Choice C reason: Neurogenic bladder is a dysfunction of the bladder caused by a nerve problem. It can affect the ability to store or empty urine. It can cause urinary retention, which increases the pressure in the urinary tract and damages the kidneys. This is a type of postrenal acute kidney injury, which is a result of obstruction to the urine outflow.

Choice D reason: Renal calculus is a solid mass formed from crystals in the urine. It can block the ureter, the tube that carries urine from the kidney to the bladder. It can cause hydronephrosis, which is a swelling of the kidney due to accumulation of urine. This is another type of postrenal acute kidney injury.

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A client develops edema of the left arm and hand following a left radical mastectomy. The nurse explains the cause of the edema. Which explanation is correct?

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