A patient, diagnosed with multiple organ dysfunction syndrome, is developing pulmonary edema. The nurse realizes that the edema is caused by
1. tissue hypoxia.
2. unregulated apoptosis.
3. uncontrolled systemic inflammation.
4. microvascular coagulopathy.
3
Rationale: During sepsis, early activation of immune cells is followed by down regulation of their activity that leads to a state of immune deficiency and increased risk of superinfection. Proinflammatory mediators increase capillary permeability resulting in edema in organs such as the lungs. This is why the patient is developing pulmonary edema. Evidence of tissue hypoxia will occur in the gastrointestinal tract and the brain first. Unregulated apoptosis is uncontrollable cellular death. Pulmonary edema is not a symptom of unregulated apoptosis. Microvascular coagulopathy will manifest as abnormal clotting factors and micro-embolism production.
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