The nurse is caring for a client with diverticulitis who presents with fever and acute lower left quadrant abdominal pain. Which pathophysiologic mechanism supports the client’s clinical presentation?

Choice A reason: A furuncle is a painful abscess caused by Staphylococcus aureus infecting a hair follicle, leading to purulent, tender nodules. This bacterial etiology is the primary risk factor, as S. aureus colonizes skin and invades follicles, causing localized infection. This aligns with dermatological pathology for furuncle development.

Choice B reason: Insect or spider bites may cause secondary infections but are not the primary etiology of furuncles. Furuncles specifically result from S. aureus folliculitis. Bites cause different lesions, like cellulitis, making this incorrect for the typical pathological process leading to a furuncle’s formation.

Choice C reason: Inadequate blood supply may impair healing but does not directly cause furuncles. S. aureus infection of hair follicles is the primary etiology. Poor perfusion is a risk for chronic wounds, not acute folliculitis, making this incorrect for the pathological etiology of a furuncle.

Choice D reason: Sexual contact with an infected partner may transmit STDs but is unrelated to furuncles, which are caused by S. aureus skin infections. Furuncles are not sexually transmitted, making this incorrect, as the etiology is bacterial colonization of hair follicles, not interpersonal transmission.

Choice A reason: Hypertension increases cardiac workload, causing left ventricular hypertrophy and eventual heart failure. Chronic high blood pressure impairs the heart’s pumping ability, a leading cause of HF in older adults. This history is strongly associated with HF development, per cardiovascular pathophysiology evidence.

Choice B reason: Renal lithiasis (kidney stones) causes pain or obstruction but is not directly linked to heart failure. While renal issues may complicate HF management, lithiasis itself does not strain the heart or cause HF, making it irrelevant to the client’s HF development history.

Choice C reason: Atrial fibrillation reduces cardiac efficiency by impairing atrial contraction, decreasing cardiac output, and increasing HF risk. In older adults, it can cause tachycardia-induced cardiomyopathy, exacerbating HF. This arrhythmia is a significant contributor to HF, supported by cardiology evidence.

Choice D reason: Emphysema, a COPD form, causes pulmonary hypertension and right heart strain, leading to right-sided HF (cor pulmonale). Chronic hypoxia from emphysema exacerbates cardiac stress, contributing to HF in comorbid patients, making it a relevant historical factor for HF development.

Choice E reason: Gouty arthritis involves uric acid crystal deposition, causing joint inflammation but not cardiac strain. While linked to metabolic syndrome, it does not directly cause HF. Other factors like hypertension are more directly associated, making gout irrelevant to HF development in this client.