What can cause hyponatremia?

Choice A reason: Stage 1 pressure ulcers present with intact skin showing non-blanchable redness, typically over bony prominences, due to localized ischemia from sustained pressure. No skin loss or blistering occurs, as the epidermis remains intact, indicating early tissue stress without ulceration. This does not match the described blister and skin loss, making it incorrect.

Choice B reason: Stage 4 pressure ulcers involve full-thickness tissue loss, exposing underlying structures like muscle, bone, or tendons. Severe necrosis and deep tissue damage occur due to prolonged pressure, disrupting blood supply extensively. The described superficial skin loss with a blister does not involve such deep structures, ruling out Stage 4.

Choice C reason: Stage 3 pressure ulcers feature full-thickness skin loss, extending into subcutaneous tissue but not to muscle or bone. They may show undermining or tunneling due to tissue necrosis. The described blister with top-layer skin loss suggests partial-thickness damage, not deep enough for Stage 3, making this choice incorrect.

Choice D reason: Stage 2 pressure ulcers involve partial-thickness skin loss, affecting the epidermis and possibly dermis, often appearing as a shallow ulcer or fluid-filled blister. The blister and loss of the top skin layer described indicate damage beyond redness but not full-thickness, aligning perfectly with Stage 2 characteristics, making this the correct choice.

A. Hernia causes mechanical bowel obstruction by physically trapping or compressing the intestine, preventing content passage. This aligns with the patient’s hernia, creating a structural blockage consistent with clinical findings.

B. Hypokalemia leads to functional bowel obstruction by disrupting intestinal motility through electrolyte imbalances, impairing muscle contractions without physical blockage. This matches the patient’s hypokalemia, exacerbating adynamic ileus.

C. Anesthesia from surgery causes functional bowel obstruction by slowing intestinal peristalsis, often resulting in postoperative ileus. This aligns with the patient’s recent anesthesia exposure, disrupting coordinated muscle contractions.

D. Intestinal tumor results in mechanical bowel obstruction by physically blocking or compressing the intestinal lumen, impeding content flow. The patient’s tumor aligns with this mechanism, a common cause of mechanical obstruction.

E. Pancreatitis contributes to functional bowel obstruction by causing inflammation or retroperitoneal irritation, leading to adynamic ileus without physical blockage. This matches the patient’s pancreatitis, disrupting intestinal motility.

F. Adhesions cause mechanical bowel obstruction by forming fibrous bands that kink or compress the intestine, blocking content passage. The patient’s adhesion history aligns with this, a leading cause of small bowel obstruction