The nurse provides care for a client diagnosed with systemic lupus erythematosus. Which finding does the nurse expect to assess?

Choice A reason: Blood flow is diverted from the abdominal muscles to the liver due to increased intravascular pressure is not the best description because it is a condition that affects the distribution of blood in the body, not the accumulation of fluid in the abdomen. Intravascular pressure is the pressure exerted by the blood on the walls of the blood vessels, which can be affected by various factors, such as blood volume, cardiac output, or vascular resistance. Increased intravascular pressure can cause blood flow to be diverted from the peripheral areas, such as the abdominal muscles, to the central areas, such as the liver, which can result in symptoms such as portal hypertension, which is a high blood pressure in the vein that carries blood from the digestive organs to the liver.

Choice B reason: Vasodilation of the mesenteric blood vessels promotes movement of sodium into the peritoneum is not the best description because it is a condition that affects the diameter of the blood vessels in the abdomen, not the accumulation of fluid in the abdomen. Vasodilation is the widening of the blood vessels, which can be caused by various factors, such as nitric oxide, prostaglandins, or histamine. Vasodilation of the mesenteric blood vessels, which are the blood vessels that supply the intestines, can increase the blood flow and the permeability of the capillaries, which are the smallest blood vessels, allowing sodium and water to move from the blood to the peritoneum, which is the membrane that covers the abdominal organs and the abdominal wall. However, this is not the main mechanism for ascites development in this client, because the amount of sodium and water that moves through the capillaries is normally balanced by the lymphatic system, which is a network of vessels that drains the excess fluid and returns it to the blood.

Choice C reason: Fluid moves from the intravascular space to the interstitial space due to decreased serum albumin levels is the best description because it is a condition that affects the osmotic pressure of the blood, which is the main mechanism for ascites development in this client. Osmotic pressure is the pressure that is exerted by the solutes, such as proteins, in a solution, which determines the movement of water across a semipermeable membrane, such as the capillary wall. Albumin is the most abundant protein in the blood, which is produced by the liver and helps to maintain the osmotic pressure of the blood. Decreased serum albumin levels can be caused by various factors, such as liver failure, malnutrition, or inflammation. Decreased serum albumin levels can reduce the osmotic pressure of the blood, which means that the blood cannot retain enough water, causing fluid to move from the intravascular space, which is the space within the blood vessels, to the interstitial space, which is the space between the cells and the blood vessels. This can result in edema, which is the swelling of the tissues due to fluid accumulation, especially in the abdomen, which is called ascites.

Choice D reason: The liver metabolizes increased amounts of antidiuretic hormone and aldosterone is not the best description because it is a condition that affects the hormonal regulation of water and sodium balance, not the accumulation of fluid in the abdomen. Antidiuretic hormone and aldosterone are hormones that help the kidneys retain water and sodium, respectively, and regulate the fluid and electrolyte balance in the body. Antidiuretic hormone is produced by the hypothalamus and secreted by the pituitary gland, while aldosterone is produced by the adrenal glands. The liver is involved in the metabolism and clearance of these hormones, which means that it breaks them down and removes them from the blood. Increased amounts of antidiuretic hormone and aldosterone can be caused by various factors, such as dehydration, heart failure, or renal failure. Increased amounts of antidiuretic hormone and aldosterone can cause the kidneys to reabsorb more water and sodium, which can increase the blood volume and the blood pressure, but this is not the main mechanism for ascites development in this client, because the fluid that accumulates in the abdomen is not from the kidneys, but from the capillaries.

Choice A reason: Inflammation of white matter in the brain and spinal cord is not the best explanation because it is a condition that affects the transmission of nerve impulses, not the perception of sensory stimuli. White matter is the part of the nervous system that consists of myelinated axons, which are the extensions of nerve cells that carry electrical signals from one cell to another. Inflammation of white matter can be caused by various factors, such as infections, autoimmune diseases, or trauma, and can result in symptoms such as weakness, numbness, or paralysis.

Choice B reason: Increased levels of gamma-aminobutyric acid (GABA) in the brain stem is not the best explanation because it is a condition that affects the regulation of muscle tone, not the perception of sensory stimuli. GABA is a neurotransmitter, which is a chemical messenger that transmits signals between nerve cells. GABA is an inhibitory neurotransmitter, which means that it reduces the activity of the nerve cells that it binds to. GABA is mainly found in the brain stem, which is the part of the brain that connects the spinal cord to the cerebrum and cerebellum, and controls vital functions such as breathing, heart rate, and blood pressure. Increased levels of GABA in the brain stem can cause symptoms such as spasticity, rigidity, or tremors.

Choice C reason: Decreased levels of endorphins in the pons and medulla is not the best explanation because it is a condition that affects the modulation of pain, not the perception of sensory stimuli. Endorphins are neurotransmitters that act as natural painkillers, by binding to the opioid receptors in the brain and spinal cord, and blocking the transmission of pain signals. Endorphins are produced by the pituitary gland and the hypothalamus, which are parts of the brain that regulate the hormonal and nervous systems. The pons and the medulla are parts of the brain stem that are involved in the control of voluntary and involuntary movements, such as chewing, swallowing, coughing, sneezing, and blinking. Decreased levels of endorphins in the pons and the medulla can cause symptoms such as increased sensitivity to pain, anxiety, or depression.

Choice D reason: Hypoxia and necrosis of the parietal lobe neurons is the best explanation because it is a condition that affects the processing of sensory stimuli, such as touch, pain, temperature, and position. The parietal lobe is the part of the cerebrum that is responsible for integrating and interpreting sensory information from different parts of the body. The parietal lobe is divided into two hemispheres, each corresponding to the opposite side of the body. A left-sided intracerebral hemorrhage is a condition where a blood vessel in the left parietal lobe ruptures, causing bleeding and swelling in the brain tissue. This can damage the neurons, which are the nerve cells that communicate with each other and form the basis of the nervous system. Hypoxia and necrosis of the parietal lobe neurons can cause symptoms such as loss of sensation, neglect, or agnosia on the right side of the body.