A female client was horseback riding when her horse slipped and fell on her leg, crushing but not breaking it, and resulting in a large amount of edema over the crushed area. Which pathophysiological mechanism is responsible for the edema?

Increase in interstitial osmotic pressure due to cellular damage.

Decrease in interstitial pressures due to low blood pressure.

Increased intravascular osmotic pressure due to crushing injury.

Increased intravascular hydrostatic pressure due to trauma.

Answer and Explanation

The Correct Answer is A

A. Increase in interstitial osmotic pressure due to cellular damage. A crushing injury damages cells, leading to the release of intracellular proteins and solutes into the interstitial space. This increases interstitial osmotic pressure, drawing fluid from the blood vessels into the injured tissues, causing edema. The inflammatory response further contributes to capillary permeability and fluid leakage.
B. Decrease in interstitial pressures due to low blood pressure. Blood pressure does not directly regulate interstitial pressure in a localized trauma area. Even if systemic blood pressure were low, localized edema can still occur due to tissue damage and increased capillary permeability.
C. Increased intravascular osmotic pressure due to crushing injury. Osmotic pressure in the blood is primarily determined by plasma proteins, such as albumin. A crushing injury does not increase intravascular osmotic pressure; instead, it increases interstitial osmotic pressure, pulling fluid out of the blood vessels.
D. Increased intravascular hydrostatic pressure due to trauma. While trauma can cause localized vascular changes, hydrostatic pressure primarily affects systemic circulation. In this case, localized tissue damage and inflammation—not increased intravascular pressure—are responsible for edema formation.

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Correct Answer is D

Explanation

A. Cell division occurs with the replication of parent cell's DNA distributed to daughter cells with duplicated chromosomes. This describes normal cell division (mitosis), not cancerous growth. In healthy cells, division is controlled, and errors are corrected by regulatory mechanisms.
B. Cells proliferate until a finite cell density is reached, which is determined by the availability of growth factors. Normal cells exhibit contact inhibition, meaning they stop dividing when they reach a certain density. Cancer cells ignore these regulatory signals and continue to grow uncontrollably.
C. Abnormal cell growth that remains confined to its original location, without invading surrounding tissue or spreading. This describes benign tumors, which do not spread. Cancerous (malignant) tumors, however, invade nearby tissues and can metastasize to distant organs.
D. Alteration of cellular genetics proliferates a mutated cell that progresses to surrounding and distant tissues. Cancer begins with genetic mutations that cause uncontrolled cell proliferation. As cancer progresses, cells invade surrounding tissues and may spread (metastasize) to distant sites via the blood and lymphatic systems. This is the defining characteristic of malignancy.

A. Immobility B. Obesity C. Inadequate nutritional intake D. Incontinence E. Decreased sensory perception F. Coarse lung sounds G. Diabetes mellitus

Correct Answer is ["A","B","C","D","E","G"]

Explanation

A. Immobility. The client requires a walker for mobility and reports difficulty repositioning in bed. Limited mobility increases the risk of pressure injuries due to prolonged pressure on certain areas, reducing blood flow and oxygen delivery to the skin.
B. Obesity. The client has a history of moderate obesity, which increases skin friction, moisture retention, and difficulty with self-care. Excess weight places additional pressure on bony prominences, elevating the risk of pressure ulcers.
C. Inadequate nutritional intake. The client has a poor appetite and decreased oral intake, which can lead to protein and nutrient deficiencies. Poor nutrition impairs skin integrity and delays wound healing, further increasing the risk of pressure injuries.
D. Incontinence. The client wears an incontinence brief due to occasional urinary and fecal accidents. Constant exposure to moisture from urine and stool can break down the skin barrier, making it more susceptible to infections and pressure injuries.
E. Decreased sensory perception. The client reports neuropathy in both hands and lower legs, reducing sensation. Impaired sensation can prevent the recognition of pressure, pain, or injury, leading to delayed intervention and increased risk of skin breakdown.
F. Coarse lung sounds. While coarse lung sounds may indicate respiratory congestion or infection, they do not directly contribute to skin injury risk. This factor is less relevant compared to others affecting skin integrity.
G. Diabetes mellitus. The client has poorly controlled type 1 diabetes, which impairs circulation and delays wound healing. Chronic hyperglycemia can lead to reduced immune response and increased susceptibility to infections and pressure ulcers.

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A female client was horseback riding when her horse slipped and fell on her leg, crushing but not breaking it, and resulting in a large amount of edema over the crushed area. Which pathophysiological mechanism is responsible for the edema?

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Correct Answer is D

Explanation

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Explanation

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A female client was horseback riding when her horse slipped and fell on her leg, crushing but not breaking it, and resulting in a large amount of edema over the crushed area. Which pathophysiological mechanism is responsible for the edema?

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