Severe edema occurs in individuals with large burn injuries due to:
Increased capillary permeability.
Decreased metabolism of carbohydrates.
Decreased hematocrit in the blood.
Increased circulating blood volume.
The Correct Answer is A
A. Increased capillary permeability is correct because severe burns trigger an inflammatory response that damages the capillary walls. This damage allows plasma, proteins, and fluid to leak into the surrounding interstitial tissue, leading to edema. The combination of fluid shift and protein loss from the intravascular space causes hypovolemia and localized or generalized swelling. This phenomenon, known as burn shock or fluid shift, is a hallmark of major burn injuries.
B. Decreased metabolism of carbohydrates is incorrect because carbohydrate metabolism does not directly cause edema. While burn injuries can affect metabolic rate, the primary cause of fluid accumulation is vascular leakage, not metabolic dysfunction.
C. Decreased hematocrit in the blood is incorrect because hematocrit often increases initially after burns due to plasma loss into the interstitial space. Decreased hematocrit may occur later if fluid resuscitation dilutes the blood, but this is not the cause of edema.
D. Increased circulating blood volume is incorrect because circulating blood volume actually decreases in the acute phase of large burns due to plasma leakage. Edema occurs outside the blood vessels, not from an excess of blood within them.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Decreased lung compliance and atelectasis is incorrect because these changes are associated with restrictive lung diseases, such as pulmonary fibrosis or ARDS, which limit lung expansion but do not typically cause wheezing. Wheezing is a sign of airway obstruction, not reduced lung compliance.
B. Pulmonary fibrosis and scarring is incorrect because fibrosis leads to stiff, noncompliant lungs and impaired gas exchange. Although it may cause shortness of breath, it does not directly cause wheezing, which results from narrowed airways.
C. Alveolar fluid accumulation and edema is incorrect because fluid in the alveoli, as seen in pulmonary edema or pneumonia, causes crackles (rales) and dyspnea, not wheezing. Wheezing occurs primarily in the bronchi and bronchioles, not the alveoli.
D. Airway inflammation and bronchoconstriction is correct because asthma is characterized by chronic airway inflammation, hyperresponsiveness, and bronchospasm. These processes narrow the small airways, leading to turbulent airflow during exhalation, which produces the high-pitched musical sound known as wheezing. Other asthma manifestations include coughing, chest tightness, and shortness of breath, often triggered by allergens, exercise, cold air, or respiratory infections.
Correct Answer is B
Explanation
A. Increased venous pressure causing edema in the legs is incorrect because edema and venous congestion are associated with venous insufficiency, not intermittent claudication. Intermittent claudication is an arterial problem, not a venous one.
B. Decreased blood flow in leg muscles due to atherosclerosis is correct because atherosclerotic plaques narrow the arteries, reducing oxygen-rich blood flow to the muscles during activity. When the leg muscles require more oxygen during exercise or walking, the insufficient blood supply leads to ischemia, causing pain, cramping, or fatigue. This pain typically resolves with rest, which is why it is called intermittent claudication.
C. Increased cardiac output leading to muscle fatigue is incorrect because the pain is not due to cardiac output. While heart function affects overall perfusion, intermittent claudication is localized ischemic pain in the leg muscles caused by arterial obstruction, not by the heart pumping more blood.
D. Decreased stimulation of nerves in the leg muscles is incorrect because the pain results from ischemia, not nerve inactivity. In fact, nerve endings in the muscles may contribute to the sensation of pain due to oxygen deprivation, but the primary cause is reduced arterial blood flow.
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