The nurse provides care for a client who has a history of renal calculi. Which type of renal calculi is most common in clients with gout?

Choice A reason: Appendicitis and peritonitis are not the most common cause of small bowel obstruction in adults because they are conditions that affect the appendix and the peritoneum, which are parts of the large intestine, not the small intestine. The appendix is a small pouch that is attached to the cecum, which is the first part of the large intestine. The peritoneum is a membrane that covers the abdominal organs and the abdominal wall. Appendicitis is a condition where the appendix becomes inflamed, causing symptoms such as pain, fever, or nausea. Peritonitis is a condition where the peritoneum becomes inflamed, usually due to an infection or a perforation of the abdominal organs, causing symptoms such as pain, fever, or shock.

Choice B reason: Sigmoid colon cancer is not the most common cause of small bowel obstruction in adults because it is a condition that affects the sigmoid colon, which is the last part of the large intestine, not the small intestine. The sigmoid colon is a curved segment that connects the descending colon to the rectum, which is the final part of the digestive tract. Sigmoid colon cancer is a type of cancer that develops from the cells that line the inner wall of the sigmoid colon, causing symptoms such as bleeding, change in bowel habits, or weight loss.

Choice C reason: Cirrhosis and ascites are not the most common cause of small bowel obstruction in adults because they are conditions that affect the liver and the abdomen, not the small intestine. The liver is a large organ that performs various functions, such as detoxifying the blood, producing bile, and metabolizing nutrients. The abdomen is the cavity that contains the digestive organs, such as the stomach, the small intestine, and the large intestine. Cirrhosis is a condition where the liver becomes scarred and damaged, usually due to chronic alcohol abuse, viral hepatitis, or fatty liver disease, causing symptoms such as jaundice, fatigue, or bleeding. Ascites is a condition where fluid accumulates in the abdomen, usually due to portal hypertension, which is a high blood pressure in the vein that carries blood from the digestive organs to the liver. Portal hypertension can be a complication of cirrhosis, and can cause symptoms such as abdominal distension, shortness of breath, or infection.

Choice D reason: Adhesions of the small intestine are the most common cause of small bowel obstruction in adults because they are bands of scar tissue that form between the loops of the small intestine, which is the part of the digestive tract that extends from the stomach to the large intestine, and is responsible for digesting and absorbing nutrients. Adhesions of the small intestine can block or twist the passage of food and fluid, causing symptoms such as pain, vomiting, or constipation. Adhesions of the small intestine can be caused by various factors, such as surgery, infection, or inflammation.

Choice A reason: Initiates the fibrinolytic process in the arteries is not a role of inflammation in the development of atherosclerosis, but a protective mechanism against it. Fibrinolysis is the breakdown of blood clots by enzymes such as plasmin. It prevents the formation of thrombi that can occlude the arteries and cause ischemia.

Choice B reason: Decreases highly sensitive C-reactive protein (hsCRP) levels is not a role of inflammation in the development of atherosclerosis, but an indicator of it. hsCRP is a marker of systemic inflammation that is produced by the liver in response to cytokines. It is elevated in patients with atherosclerosis and correlates with the risk of cardiovascular events.

Choice C reason: Damages the endothelium of the arteries is the main role of inflammation in the development of atherosclerosis. Endothelial injury exposes the subendothelial layer to the blood, which triggers the adhesion of monocytes and platelets. Monocytes differentiate into macrophages and engulf oxidized low-density lipoproteins (LDL), forming foam cells. Foam cells accumulate in the intima and form fatty streaks, which are the earliest lesions of atherosclerosis.

Choice D reason: Causes diffuse arterial vasoconstriction is not a role of inflammation in the development of atherosclerosis, but a consequence of it. Atherosclerosis narrows the lumen of the arteries and reduces the blood flow to the tissues. This causes ischemia, which stimulates the release of vasoconstrictors such as angiotensin II and endothelin. Vasoconstriction further worsens the ischemia and increases the blood pressure.