Medical Surgical Liver Cirrhosis #5

Question

The nurse provides care for a client who is diagnosed with ascites and finds that the client’s abdominal girth has increased by 7 cm over the past three days. The nurse determines the reasons for increased size includes which finding? (Select all that apply.)

Answers

  1. Thirst occurs causing excess fluid intake
    • Rationale:

      Thirst does not contribute to the accumulation of fluid in the abdominal cavity; therefore, this is not a reason for the ascites. Ascites related to cirrhosis is caused by decreased colloid oncotic pressure which results from the liver’s inability to synthesize albumin. Portal hypertension shifts protein from blood vessels into the peritoneal cavity, and hyperaldosteronism increases sodium and fluid retention.

  2. Hyperaldosteronism increase sodium and fluid retention
    • Rationale:

      Hyperaldosteronism increases sodium and fluid retention thus leading to the accumulation of fluid in the abdominal cavity that results in ascites. Ascites related to cirrhosis is also caused by decreased colloid oncotic pressure which results from the liver’s inability to synthesize albumin. Portal hypertension shifts protein from blood vessels into the peritoneal cavity.

  3. Liver is unable to synthesize albumin and decreased colloid oncotic pressure occurs
    • Rationale:

      Ascites related to cirrhosis is caused by decreased colloid oncotic pressure which results from the liver’s inability to synthesize albumin. Ascites related to cirrhosis is also caused by portal hypertension shifts protein from blood vessels into the peritoneal cavity and hyperaldosteronism increases sodium and fluid retention.

  4. Blood proteins are pushed out of the blood vessels, causing leakage into the peritoneal cavity
    • Rationale:

      Portal hypertension shifts protein from blood vessels into the peritoneal cavity. Ascites related to cirrhosis is also caused by decreased colloid oncotic pressure which results from the liver’s inability to synthesize albumin. Also, hyperaldosteronism increases sodium and fluid retention.

  5. Low blood pressure in the portal vein causing increased fluid retention
    • Rationale:

      This answer is incorrect because it is high blood pressure in the portal vein, not low that causes ascites. This is called portal hypertension which shifts protein from the blood vessels into the peritoneal cavity thus causing the abdomen to swell.

Overview

Ascites is defined as abdominal swelling caused by an accumulation of fluid. Ascites related to cirrhosis is caused by decreased colloid oncotic pressure which results from the liver’s inability to synthesize albumin. Portal hypertension shifts protein from blood vessels into the peritoneal cavity, and hyperaldosteronism increases sodium and fluid retention.

Explanation

Learning Outcomes

Cirrhosis is a late stage of scarring (i.e., fibrosis) of the liver caused by many different liver diseases and conditions (e.g., hepatitis, chronic alcoholism). In cirrhosis of the liver, ascites results from high pressure in the blood vessels of the liver (i.e., portal hypertension) and low levels of albumin (a protein) within the body. Conditions that cause liver damage can lead to ascites and include alcohol abuse, certain types of cancer, and hepatitis B and hepatitis C infections. Ascites related to cirrhosis is caused by decreased colloid oncotic pressure which results from the liver’s inability to synthesize albumin. Portal hypertension shifts protein from blood vessels into the peritoneal cavity, and hyperaldosteronism increases sodium and fluid retention.

Test Taking Tip

When answering select all that apply (SATA) questions, consider each statement as true or false.

Video Rationale