The nurse is caring for a client who is admitted with polycystic kidney disease (PKD), flank pain, and hematuria. The client's blood pressure is 180/100 mm Hg. Which pathophysiological process supports the client's blood pressure finding?

Intravascular fluid deficit.

Renin angiotensin mechanism.

Inflammatory process of bladder mucosa.

Mineral precipitation in urine.

Answer and Explanation

The Correct Answer is B

Polycystic kidney disease (PKD) is a genetic disorder characterized by the formation of multiple fluid-filled cysts in the kidneys. One of the complications associated with PKD is hypertension, which often occurs due to activation of the renin-angiotensin-aldosterone system (RAAS). Here's how the pathophysiological process of the RAAS contributes to the client's elevated blood pressure:

A) Intravascular fluid deficit:

In polycystic kidney disease, the development of multiple cysts in the kidneys can impair renal function and lead to decreased filtration and reabsorption capacity. However, this impairment typically leads to fluid retention rather than intravascular fluid deficit, contributing to hypertension rather than hypotension.

B) Renin angiotensin mechanism:

Correct. In PKD, the cysts disrupt normal kidney architecture and function, leading to activation of the renin-angiotensin-aldosterone system (RAAS). Reduced renal blood flow and glomerular filtration rate (GFR) stimulate the release of renin from the juxtaglomerular cells of the kidneys. Renin acts on angiotensinogen to convert it into angiotensin I, which is then converted to angiotensin II by angiotensin-converting enzyme (ACE). Angiotensin II is a potent vasoconstrictor that increases peripheral vascular resistance, leading to elevated blood pressure. Additionally, angiotensin II stimulates the secretion of aldosterone, which promotes sodium and water retention, further contributing to hypertension.

C) Inflammatory process of bladder mucosa:

This option is not directly related to the pathophysiological process of hypertension in polycystic kidney disease. Flank pain and hematuria in PKD are often associated with cyst rupture or hemorrhage within the cysts rather than an inflammatory process of the bladder mucosa.

D) Mineral precipitation in urine:

Mineral precipitation in urine, such as the formation of kidney stones, can occur in polycystic kidney disease but is not directly associated with hypertension. Kidney stones may contribute to flank pain and hematuria but do not typically cause systemic hypertension.

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Correct Answer is C

Explanation

A. Herpes simplex virus:

While herpes simplex virus (HSV) infection is a sexually transmitted infection that can cause genital ulcers and lesions, it is not directly associated with an increased risk of cervical cancer. However, individuals with genital herpes may have an increased risk of acquiring human papillomavirus (HPV), which is a significant risk factor for cervical cancer.

B. Vulvovaginitis:

Vulvovaginitis refers to inflammation or infection of the vulva and vagina and can be caused by various factors, including bacterial, fungal, or viral infections. While chronic inflammation or infection may contribute to cellular changes in the cervix, it is not a direct risk factor for cervical cancer.

C. Human papillomavirus (HPV):

Human papillomavirus (HPV) infection is the most significant risk factor for developing cervical cancer. Certain high-risk strains of HPV, particularly HPV types 16 and 18, are strongly associated with the development of cervical dysplasia and cervical cancer. Persistent infection with high-risk HPV strains can lead to cellular changes in the cervix, eventually progressing to cervical cancer.

D. Chronic yeast infections:

Chronic yeast infections, also known as recurrent vulvovaginal candidiasis, are caused by the overgrowth of Candida species in the vaginal area. While chronic yeast infections can cause discomfort and recurrent symptoms, they are not directly linked to an increased risk of cervical cancer. However, chronic irritation or inflammation in the genital area may increase the susceptibility to other infections, including HPV.

A. Shivering. B. Purulent drainage. C. Temperature of 102° F (37.8° C). D. Redness and localized heat.

Correct Answer is D

Explanation

A) Shivering:

Shivering is not a normal inflammatory response to wound healing. It may indicate systemic symptoms such as fever or chills, which could be indicative of infection or other complications.

B) Purulent drainage:

Purulent drainage (pus) is often a sign of infection rather than a normal inflammatory response to wound healing. While some serous or serosanguinous drainage may be expected initially, purulent drainage suggests an abnormal response.

C) Temperature of 102° F (37.8° C):

A temperature of 102° F (37.8° C) is indicative of fever, which can occur in response to infection or inflammation. While fever is part of the inflammatory response, it is not necessarily considered a normal finding in the context of wound healing and may indicate an abnormal response such as infection.

D) Redness and localized heat:

Correct. Redness (erythema) and localized heat are typical signs of the inflammatory phase of wound healing. Inflammation is a normal response to tissue injury and is characterized by increased blood flow to the area, resulting in redness and warmth. These signs indicate that the body's immune response is active and working to repair the injured tissue.

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The nurse is caring for a client who is admitted with polycystic kidney disease (PKD), flank pain, and hematuria. The client's blood pressure is 180/100 mm Hg. Which pathophysiological process supports the client's blood pressure finding?

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