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 B

Explanation

A. Developmental stage. While understanding the client’s psychosocial needs is important, the ability to perform daily activities and remain independent is more critical in determining the best living environment.
B. Functional capacity. The ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs) is the most important factor in determining the appropriate living environment. Clients with limited mobility, cognitive decline, or difficulty managing self-care may require assisted living or skilled nursing care.
C. Age and gender. Age and gender alone do not determine the need for a particular living environment. Some older adults remain independent well into their later years, while others may require assistance at a younger age due to functional decline.
D. Medical diagnoses. While medical conditions influence care needs, they do not solely determine living arrangements. A client with a chronic illness who maintains functional independence may still live at home, whereas a client with minimal medical issues but significant functional decline may require assisted care.

A. Muscle aches and pains. B. Appearance of any moles. C. Pigmentation of the skin. D. Elasticity of the skin.

Correct Answer is B

Explanation

A. Muscle aches and pains. Muscle pain is not a primary concern related to melanoma recurrence. While melanoma can metastasize to other organs, localized muscle pain is not the most important characteristic to monitor post-resection.
B. Appearance of any moles. Malignant melanoma is strongly associated with abnormal moles. The client should monitor existing moles and new skin lesions using the ABCDE rule:Asymmetry, Border irregularity, Color variation, Diameter greater than 6 mm, Evolving changes (size, shape, or symptoms like itching or bleeding), Early detection of new or changing moles is critical for identifying recurrence or new melanoma development.
C. Pigmentation of the skin. Changes in overall skin pigmentation (such as tanning or lightening) are not a primary concern. Localized pigmentation changes around moles may indicate malignancy, but generalized pigmentation shifts are not the focus for melanoma monitoring.
D. Elasticity of the skin. Skin elasticity is affected by aging and sun exposure but is not a key factor in melanoma surveillance. Monitoring moles and skin lesions is far more important for early detection of recurrence.

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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 B

Explanation

Correct Answer is B

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?