A client is admitted with the diagnosis of "left-sided embolic stroke". Which explanation best describes the most likely cause of the stroke?

Choice A reason: Initiates the fibrinolytic process in the arteries is not a role of inflammation in the development of atherosclerosis, but a protective mechanism against it. Fibrinolysis is the breakdown of blood clots by enzymes such as plasmin. It prevents the formation of thrombi that can occlude the arteries and cause ischemia.

Choice B reason: Decreases highly sensitive C-reactive protein (hsCRP) levels is not a role of inflammation in the development of atherosclerosis, but an indicator of it. hsCRP is a marker of systemic inflammation that is produced by the liver in response to cytokines. It is elevated in patients with atherosclerosis and correlates with the risk of cardiovascular events.

Choice C reason: Damages the endothelium of the arteries is the main role of inflammation in the development of atherosclerosis. Endothelial injury exposes the subendothelial layer to the blood, which triggers the adhesion of monocytes and platelets. Monocytes differentiate into macrophages and engulf oxidized low-density lipoproteins (LDL), forming foam cells. Foam cells accumulate in the intima and form fatty streaks, which are the earliest lesions of atherosclerosis.

Choice D reason: Causes diffuse arterial vasoconstriction is not a role of inflammation in the development of atherosclerosis, but a consequence of it. Atherosclerosis narrows the lumen of the arteries and reduces the blood flow to the tissues. This causes ischemia, which stimulates the release of vasoconstrictors such as angiotensin II and endothelin. Vasoconstriction further worsens the ischemia and increases the blood pressure.

Choice A reason: Numbness and tingling of the fingers and toes is not the expected finding because it is a sign of alkalosis, not acidosis. Alkalosis is a condition where the blood has a high pH, which means that it is too basic or alkaline. Alkalosis can cause numbness and tingling of the fingers and toes due to hypocalcemia, which is a low level of calcium in the blood, or hypokalemia, which is a low level of potassium in the blood. Both conditions can affect the nerve and muscle function, causing paresthesia, which is an abnormal sensation of the skin.

Choice B reason: A diffuse headache described as "throbbing" is the expected finding because it is a sign of acidosis, which is a condition where the blood has a low pH, which means that it is too acidic. Acidosis can cause a diffuse headache described as "throbbing" due to vasodilation, which is the widening of the blood vessels, especially in the brain. Vasodilation can increase the blood flow and the pressure in the head, causing pain and discomfort.

Choice C reason: Flushed skin that is warm to the touch is not the expected finding because it is a sign of fever, not salicylate toxicity. Fever is a condition where the body temperature is higher than normal, usually due to an infection or inflammation. Fever can cause flushed skin that is warm to the touch due to increased blood flow to the skin, which helps to dissipate the excess heat.

Choice D reason: Decreased muscle strength and deep tendon reflexes is not the expected finding because it is a sign of neuromuscular blockade, not salicylate toxicity. Neuromuscular blockade is a condition where the communication between the nerves and the muscles is impaired, causing paralysis or weakness. Neuromuscular blockade can be caused by various factors, such as medications, toxins, or diseases, that interfere with the transmission of acetylcholine, which is a neurotransmitter that stimulates the muscle contraction.