A patient is severely dehydrated from vomiting and diarrhea causing his or her blood to become hypertonic. What effects does the nurse expect this will have on the red blood cells

The blood cells will migrate to the bone marrow

the red cells will precipitate out of circulation

They will swell and eventually rupture

The cells will shrink and shrivel, decreasing their oxygen-carrying ability

Answer and Explanation

The Correct Answer is D

A) The blood cells will migrate to the bone marrow:
While the bone marrow is responsible for producing red blood cells, dehydration and hypertonicity of the blood would not cause the red blood cells to migrate to the bone marrow. Migration of blood cells typically refers to white blood cells moving toward sites of infection or inflammation, not a response to dehydration.

B) The red cells will precipitate out of circulation:
Red blood cells do not precipitate out of circulation due to dehydration or hypertonic conditions. Instead, dehydration causes a shift in water balance that leads to changes in the shape and function of the red blood cells. Precipitation of cells is not a physiological response in this context.

C) They will swell and eventually rupture:
In conditions of hypertonicity, where the concentration of solutes (such as sodium) in the blood is higher than normal, red blood cells actually shrink, not swell. When blood is hypertonic, water moves out of the red blood cells into the extracellular space to balance the osmotic pressure, leading to cell shrinkage. Cells only swell in hypotonic conditions, when water moves into the cell.

D) The cells will shrink and shrivel, decreasing their oxygen-carrying ability:
When the body becomes dehydrated, the blood becomes hypertonic (more concentrated), leading to a shift of water out of the red blood cells to try to balance the osmotic gradient. As a result, the red blood cells shrink and shrivel. This shrinkage can impair their ability to carry oxygen effectively, as the cells may become more rigid and less flexible, making it difficult for them to navigate through small blood vessels and perform gas exchange in the lungs and tissues.

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Correct Answer is A

Explanation

A) Beta 1: Beta-1 adrenergic receptors are primarily located in the heart and are responsible for increasing heart rate (chronotropy), the force of contraction (inotropy), and the conduction speed of electrical impulses within the heart (dromotropy). When a drug is given to increase heart rate and myocardial activity, it is stimulating the beta-1 receptors, which enhance the heart's performance..

B) Beta 2: Beta-2 receptors are predominantly found in smooth muscles, such as those
in the bronchi, blood vessels, and uterus. Stimulation of beta-2 receptors leads to relaxation of these muscles, including bronchodilation and vasodilation, which would not have a direct effect on increasing heart rate or myocardial activity.

C) Alpha 2: Alpha-2 receptors are primarily located in the central nervous system (CNS) and act to inhibit the release of norepinephrine, leading to a reduction in sympathetic nervous system activity. They have the opposite effect of what is desired in this case, as stimulation of alpha-2 receptors would actually lower heart rate and decrease myocardial activity, not increase it.

D) Alpha 1: Alpha-1 receptors are found in the smooth muscle of blood vessels and when stimulated, cause vasoconstriction, which increases blood pressure. While alpha-1 receptors do affect the cardiovascular system, they do not directly influence heart rate or myocardial contractility.

A. decreased sweating, decreased BP, and increased heart rate B. Increased sweating, decreased respiratory rate, and increased BP C. Pupil constriction, increased respiratory rate, and decreased heart rate D. Increased blood pressure, increased heart rate, and pupil dilation

Correct Answer is D

Explanation

A) Decreased sweating, decreased BP, and increased heart rate: This combination does not reflect a typical stress response. In stressful or threatening situations, the body activates the sympathetic nervous system, leading to increased sweating, elevated blood pressure, and other physiological changes, rather than a decrease in blood pressure.
B) Increased sweating, decreased respiratory rate, and increased BP: In a stressful situation, sweating would indeed increase due to the activation of the sympathetic nervous system. However, the respiratory rate would typically increase, not decrease, as the body prepares for the "fight or flight" response. Increased blood pressure is expected, but decreased respiratory rate does not align with this response.
C) Pupil constriction, increased respiratory rate, and decreased heart rate: Pupil constriction is not characteristic of the "fight or flight" response; instead, pupil dilation occurs as part of the body's preparation to react to a threat. Increased respiratory rate and heart rate are typically seen during stress, but decreased heart rate would not be expected in such a situation.
D) Increased blood pressure, increased heart rate, and pupil dilation: This is the correct response. When faced with a threatening situation, the body activates the sympathetic nervous system, triggering the "fight or flight" response. This includes increased blood pressure and heart rate to prepare the body for action, as well as pupil dilation (mydriasis) to enhance vision and perception of the environment. These changes help the body respond quickly to a perceived danger.

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