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 B

Explanation

A) Pupil dilation:
Pupil dilation is typically a response from stimulation of the sympathetic nervous system, not the parasympathetic system. The parasympathetic system tends to cause pupil constriction, so pupil dilation would not be an expected response to a parasympathetic agonist.

B) Increased gastrointestinal motility:
Stimulation of the parasympathetic nervous system, which is responsible for the "rest and digest" response, promotes the movement of food through the digestive tract, increasing gastrointestinal motility. This response is a classic sign that the parasympathetic system is being activated. Drugs that stimulate the parasympathetic nervous system often aim to enhance digestive functions.

C) Vasoconstriction:
Vasoconstriction is typically mediated by the sympathetic nervous system, not the parasympathetic system. The sympathetic nervous system activates alpha-adrenergic receptors that cause blood vessels to constrict, raising blood pressure. The parasympathetic system, on the other hand, typically promotes vasodilation, lowering blood pressure.

D) Increased heart rate:
Increased heart rate is generally associated with the sympathetic nervous system, which prepares the body for "fight or flight." The parasympathetic nervous system, in contrast, slows down the heart rate through vagal stimulation, so an increase in heart rate would not be the expected response to parasympathetic stimulation.

A. Increase in mental acuity B. Slowing of gastrointestinal motility C. Decreased production in gastric acid D. Reduction in the heart rate and blood pressure

Correct Answer is D

Explanation

A) Increase in mental acuity: Beta-adrenergic blockers (beta-blockers) do not directly affect mental acuity. In fact, some beta-blockers may cause side effects like fatigue or drowsiness, which can affect mental sharpness. Beta-blockers primarily focus on cardiovascular effects, not cognitive function, making this an unlikely therapeutic goal for their use.
B) Slowing of gastrointestinal motility: Beta-blockers can reduce sympathetic nervous system activity, which may indirectly affect the gastrointestinal system. However, slowing gastrointestinal motility is not a primary therapeutic goal of beta-blocker therapy. The main action of beta-blockers is in the cardiovascular system, not in regulating GI function.
C) Decreased production in gastric acid: Beta-blockers do not significantly reduce gastric acid production. Medications such as proton pump inhibitors or H2 blockers are typically used for managing gastric acid production or reflux. Beta-blockers focus on reducing the workload of the heart and controlling blood pressure, not on acid secretion.
D) Reduction in the heart rate and blood pressure: The primary therapeutic effect of beta-blockers is the reduction of heart rate (negative chronotropic effect) and blood pressure (due to reduced cardiac output and inhibition of the sympathetic nervous system). This is especially beneficial for managing conditions like hypertension, heart failure, and arrhythmias. It is the most likely goal of beta-blocker therapy prescribed by the provider.

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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

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Explanation

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