An older adult patient who is malnourished presents to the emergency department with a serum albumin that is low with total protein that is also low. Which clinical manifestation should the nurse expect?
Restlessness
Edema
Pallor
Confusion
The Correct Answer is B
Rationale:
A. Restlessness can occur with electrolyte imbalances or hypoxia, but it is not a hallmark of low albumin or protein malnutrition.
B. Low serum albumin and total protein decrease plasma oncotic pressure, allowing fluid to shift from the vascular space into interstitial tissues, leading to peripheral and sometimes generalized edema (anasarca).
C. Pallor is more indicative of anemia, which may coexist but is not a direct effect of hypoalbuminemia.
D. Confusion can result from electrolyte disturbances, hypoxia, or hepatic encephalopathy, but it is not a direct manifestation of low albumin.
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Related Questions
Correct Answer is D
Explanation
Rationale:
A. Tachycardia may occur secondary to hypotension, but it is a secondary concern, not the primary pharmacological issue.
B. Paracentesis does not directly affect blood glucose levels.
C. While changes in bowel habits may occur with fluid shifts, they are not the primary concern after paracentesis.
D. Removal of large volumes of ascitic fluid can lead to intravascular volume depletion, resulting in hypotension. Monitoring blood pressure before, during, and after the procedure is essential, and volume replacement may be required to maintain hemodynamic stability.
Correct Answer is B
Explanation
Rationale:
A. Vomiting is more common in small bowel obstruction and is usually less severe in large bowel obstruction.
B. A large bowel obstruction causes accumulation of gas and fecal material proximal to the blockage, leading to significant abdominal distention.
C. Large bowel obstruction may eventually cause metabolic acidosis due to impaired perfusion and tissue hypoxia, not alkalosis.
D. Back pain is not a typical sign of large bowel obstruction; the primary symptom is abdominal discomfort, distention, and constipation.
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