The nurse is explaining the underlying cause of bruising with a client who is recently diagnosed with acute leukemia. Which pathophysiology is a result of the myeloblastic dysfunction of leukemia?

A. Gastric carcinoma:

Helicobacter pylori infection is a known risk factor for the development of gastric carcinoma, or stomach cancer. Long-term follow-up is essential for clients treated for gastric ulcers caused by H. pylori infection to monitor for any signs or symptoms of gastric malignancy, such as persistent abdominal pain, unexplained weight loss, dysphagia, or gastrointestinal bleeding. Regular surveillance with endoscopic examinations may be recommended to detect any precancerous or cancerous changes in the gastric mucosa.

B. Hypokalemia:

Hypokalemia, or low potassium levels, is not directly associated with gastric ulcers caused by H. pylori infection. While certain medications used in the treatment of gastric ulcers, such as proton pump inhibitors (PPIs) or H2-receptor antagonists, may increase the risk of hypokalemia, it is not a long-term complication specifically related to H. pylori infection.

C. Kidney stones:

Kidney stones, or nephrolithiasis, are not directly associated with gastric ulcers caused by H. pylori infection. Kidney stones typically form in the kidneys and urinary tract due to factors such as dehydration, dietary factors, or metabolic disorders. While certain conditions, such as chronic kidney disease, may be associated with gastric ulcers, kidney stones are not a typical long-term complication.

D. Celiac disease:

Celiac disease is an autoimmune disorder characterized by an abnormal immune response to gluten, a protein found in wheat, barley, and rye. It is not directly associated with gastric ulcers caused by H. pylori infection. Celiac disease primarily affects the small intestine, leading to inflammation and damage to the intestinal lining in response to gluten ingestion. While individuals with celiac disease may experience gastrointestinal symptoms, they are not at increased risk for gastric ulcers specifically related to H. pylori infection.

A) The drug may be needed to treat a sudden systemic allergic reaction:

While cortisol may play a role in managing allergic reactions by suppressing inflammation, the primary reason for carrying a cortisol kit in Addison's disease is not typically related to managing allergic reactions.

B) Hypertensive crisis requires immediate treatment to prevent a stroke:

Hypertensive crisis may occur in some individuals with Addison's disease due to adrenal insufficiency, but the immediate treatment for this would typically involve fluids and intravenous hydrocortisone rather than carrying a cortisol kit for self-administration.

C) Hyperglycemia may require cortisol to lower the blood glucose level:

Cortisol can indeed influence blood glucose levels, but the need to carry a cortisol kit is primarily related to the management of adrenal insufficiency rather than hyperglycemia alone.

D) Stress increases the body's need for additional replacement hormone:

Correct. Individuals with Addison's disease have insufficient production of cortisol and often also lack aldosterone. During times of stress, such as illness, trauma, or surgery, the body's demand for cortisol increases to help cope with the stress. Inadequate cortisol production during stress can lead to adrenal crisis, a life-threatening condition. Therefore, carrying a cortisol kit allows the individual to promptly administer additional replacement hormone (usually hydrocortisone) during times of stress to prevent adrenal crisis.