A client's ankle is edematous after an ankle sprain. Which physiological mechanism is responsible for the swelling?
Histamine-mediated vascular permeability leading to fluid transudation.
Bradykinin cascade resulting in the accumulation of substance P.
Thromboxane A activation of chemical mediators.
Neutrophil migration secondary to chemotaxis.
The Correct Answer is A
A) Histamine-mediated vascular permeability leading to fluid transudation:
Correct. Ankle edema following an ankle sprain is often due to inflammation and increased vascular permeability. Histamine, released from mast cells and basophils during the inflammatory response, causes vasodilation and increases vascular permeability. This leads to the leakage of fluid from the blood vessels into the surrounding tissues, resulting in edema.
B) Bradykinin cascade resulting in the accumulation of substance P:
While bradykinin is involved in the inflammatory response and can contribute to pain and vasodilation, it does not directly cause fluid transudation leading to edema in the context of an ankle sprain.
C) Thromboxane A activation of chemical mediators:
Thromboxane A is involved in platelet aggregation and vasoconstriction rather than increasing vascular permeability and edema formation.
D) Neutrophil migration secondary to chemotaxis:
Neutrophil migration is part of the inflammatory response and can contribute to tissue damage and inflammation, but it is not the primary mechanism responsible for the development of edema following an ankle sprain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Pressure injuries, also known as pressure ulcers or bedsores, result from prolonged pressure on the skin, leading to tissue ischemia and damage. Early recognition of the pathophysiological processes involved in pressure injury development is crucial for prevention and timely intervention. Here's why option D is the correct choice:
A) Epidermal fragility and skin excoriation with serous drainage:
This description more closely aligns with the characteristics of a superficial wound or abrasion rather than the early stages of a pressure injury. In pressure injuries, epidermal breakdown may occur later in the process, after prolonged pressure and tissue ischemia.
B) Hypodermal fluid accumulation and blister formation:
While fluid accumulation and blister formation can occur in some types of wounds, such as friction blisters or burns, they are not typically characteristic of the early stages of pressure injury development. Pressure injuries primarily involve tissue ischemia and damage due to pressure and shear forces.
C) Necrotic tissue, purulent exudate, and eschar formation:
This description is more indicative of advanced or severe pressure injuries rather than the early stages. Necrotic tissue, purulent exudate, and eschar formation typically occur in pressure injuries that have progressed to deeper tissue involvement and infection.
D) Ischemic inflammatory response marked by erythemic skin:
Correct. In the early stages of pressure injury development, the affected area may exhibit signs of tissue ischemia and inflammation, which can manifest as erythema (redness) of the skin. This erythema is a result of the body's inflammatory response to tissue damage caused by pressure and may indicate the need for intervention to relieve pressure and prevent further injury.
Correct Answer is C
Explanation
Intermittent claudication is a common symptom experienced by individuals with peripheral artery disease (PAD). It occurs due to the underlying pathophysiology of arterial occlusion and ischemia during physical activity. Here's why option C is the correct choice:
A) Reduced blood flow occurs when legs are elevated:
This statement is not accurate regarding the pathophysiology of intermittent claudication in PAD. When legs are elevated, gravity assists venous return, which may actually improve blood flow temporarily. However, intermittent claudication occurs during activity, not when the legs are elevated.
B) Reddened color occurs when the feet are dependent:
This statement is unrelated to the pathophysiology of intermittent claudication. Redness when the feet are dependent may suggest venous insufficiency rather than arterial occlusion characteristic of PAD.
C) Arterial occlusion causes ischemic pain during activity:
Correct. Intermittent claudication is caused by inadequate blood flow to the muscles during physical activity due to arterial occlusion in PAD. As the demand for oxygen increases during exercise, the narrowed arteries cannot supply sufficient blood flow, leading to ischemic pain in the affected muscles. This pain typically resolves with rest and recurs upon resuming activity.
D) Reduction in blood supply leads to muscle atrophy:
Muscle atrophy may occur in severe cases of PAD with chronic ischemia, but it is not the primary cause of intermittent claudication. Intermittent claudication is primarily attributed to inadequate blood flow during activity, which results in ischemic pain rather than muscle atrophy.
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