A client with end-stage liver failure is admitted with severe cirrhosis. What is the nurse's understanding of the pathophysiology of cirrhosis?
A) Increased oncotic pressure
B) Impaired removal of bilirubin
C) Impaired conversion of ammonia to urea
D) Increased vascular permeability
D) Increased vascular permeability
Explanation: A) Albumin, which is produced in the liver, is essential for maintenance of the oncotic pressure, thus helping to maintain the vascular system. With liver damage, albumin production stops, resulting in the body fluid leaking out of the vessels into the interstitial spaces and peritoneal cavity, causing edema and ascites (an abnormal collection of fluid in the peritoneal cavity).
B) Elevated bilirubin levels leads to jaundice, not cirrhosis.
C) Impaired conversion of ammonia to urea may occur in liver damage; however, this is not the pathophysiology of cirrhosis.
D) Albumin, which is produced in the liver, is essential for maintenance of the oncotic pressure, thus helping to maintain the vascular system. With liver damage, albumin production stops, resulting in the body fluid leaking out of the vessels into the interstitial spaces and peritoneal cavity, causing edema and ascites (an abnormal collection of fluid in the peritoneal cavity).
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