28- The nurse assesses a client with cirrhosis and finds 4+ pitting edema of the feet and legs, and massive ascites. Which mechanism contributes to edema and cite in clients with cirrhosis?

a.     Decreased renin-angiotensin response to an increase in renal blood flow.

b.     Hyperaldosteronism causing an increased sodium reabsorption in renal tubules.

c.     Hypoalbuminemia that results in a decreased colloidal oncotic pressure.

d.     Decreased portacaval pressure with greater collateral circulation.

 

c. Hypoalbuminemia that results in a decreased colloidal oncotic pressure.

Step-by-step explanation

Hypoalbuminemia leads to abnormal distributions of fluids within the body and its compartments. As a result, associated symptoms include edema in the lower legs, ascites in the abdomen, and effusions around internal organs.

A decrease in oncotic pressure due to a low albumin level allows fluid to leak out from the interstitial spaces into the peritoneal cavity, producing ascites.

Patients with advanced cirrhosis almost always have hypoalbuminemia caused both by decreased synthesis by the hepatocytes and water and sodium retention that dilutes the content of albumin in the extracellular space.

Edema is the medical term for swelling. Body parts swell from injury or inflammation. It can affect a small area or the entire body. Medications, pregnancy, infections, and many other medical problems can cause edema. Edema happens when your small blood vessels leak fluid into nearby tissues.