Which statement by the nurse explains ascites?

Inflammatory molecules have increased the permeability of the abdominal capillaries

Low aldosterone levels have caused fluid retention and peritoneal edema

The liver is not manufacturing clotting factors to prevent bleeding in the peritoneum

The body is experiencing a fluid imbalance related to changing osmotic pressures

Answer and Explanation

The Correct Answer is A

Choice A reason: Ascites results from increased permeability of peritoneal capillaries, often due to inflammatory molecules like cytokines in conditions such as liver cirrhosis or portal hypertension. This allows plasma proteins and fluid to leak into the peritoneal cavity, causing fluid accumulation. This statement accurately describes the pathophysiology of ascites in liver-related disorders.

Choice B reason: Low aldosterone levels do not cause ascites; instead, high aldosterone in liver disease (e.g., cirrhosis) promotes sodium and water retention, exacerbating fluid accumulation. This statement is inaccurate, as secondary hyperaldosteronism due to reduced liver metabolism of aldosterone is a key factor in ascites development.

Choice C reason: The liver’s failure to produce clotting factors can lead to bleeding tendencies, like variceal hemorrhage, but this does not directly cause ascites. Ascites is driven by fluid leakage from capillaries, not bleeding. This statement is inaccurate, as clotting factor deficiency is unrelated to peritoneal fluid accumulation.

Choice D reason: While fluid imbalance contributes to ascites, the primary mechanism involves portal hypertension and capillary permeability, not just osmotic pressure changes. This statement is overly vague and less accurate than the specific role of inflammatory molecules increasing capillary leakage in the peritoneal cavity.

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Correct Answer is A

Explanation

Choice A reason: Furosemide, a loop diuretic, inhibits the sodium-potassium-chloride cotransporter in the thick ascending limb of the loop of Henle, preventing sodium and water reabsorption. This increases urine output significantly, often within minutes, making it highly effective for conditions like edema or heart failure, producing a rapid diuresis of up to 20% of filtered sodium.

Choice B reason: Spironolactone, a potassium-sparing diuretic, inhibits aldosterone in the distal tubule, reducing sodium reabsorption and increasing urine output. However, its diuretic effect is weaker than furosemide, as it affects only 2-3% of filtered sodium. It is primarily used for managing hyperaldosteronism or potassium retention, not rapid urine flow increase.

Choice C reason: Hydrochlorothiazide, a thiazide diuretic, inhibits sodium-chloride reabsorption in the distal convoluted tubule, increasing urine output. Its effect is milder than furosemide, impacting about 5-10% of filtered sodium. It is commonly used for hypertension but is less potent for rapid diuresis in conditions requiring significant urine flow.

Choice D reason: Mannitol, an osmotic diuretic, increases urine flow by preventing water reabsorption in the proximal tubule and loop of Henle. It is effective in acute settings like cerebral edema but less commonly used for routine diuresis compared to furosemide, which has a broader and more rapid effect on urine output.

A. Bulk-forming agents decrease the absorption of nutrients in the intestines so you will need a daily vitamin B. Fiber can exacerbate your constipation if you do not drink at least 8 glasses of water daily C. If you take fiber long term, you can become dependent on it to have a bowel movement D. Your bowel regimen will improve if you delay responding to your urge to defecate

Correct Answer is B

Explanation

Choice A reason: Bulk-forming fiber supplements, like psyllium, increase stool bulk without significantly decreasing nutrient absorption. While high doses may slightly affect mineral uptake, routine vitamin supplementation is not required. This statement is inaccurate, as nutrient malabsorption is not a primary concern with fiber supplements.

Choice B reason: Fiber supplements require adequate hydration (at least 8 glasses of water daily) to swell and soften stool, promoting bowel movements. Insufficient water can cause fiber to harden, worsening constipation. This statement is accurate, as hydration is critical for the efficacy and safety of fiber supplements.

Choice C reason: Long-term fiber use does not cause dependency; it mimics natural dietary fiber, promoting regular bowel movements. The colon adapts to increased bulk without losing intrinsic motility. This statement is inaccurate, as fiber supports, not undermines, normal bowel function in chronic use.

Choice D reason: Delaying the urge to defecate can worsen constipation by causing stool to harden and reducing rectal sensitivity. Prompt response to bowel urges promotes regularity. This statement is inaccurate, as it contradicts the goal of improving bowel regimen with fiber supplementation.

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Which statement by the nurse explains ascites?

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