A client with liver disease presents to the hospital with severe ascites. When providing care for this client, which pathophysiologic principles regarding this diagnosis will the nurse take into account?
Select all that apply.
A) Presence of portal hypertension.
B) Presence of hyperalbuminemia.
C) Increased colloidal osmotic pressure.
D) Sodium and water retention.
E) Presence of hypoaldosteronism.
Answer: A, D
Ascites is the accumulation of plasma-rich fluid in the abdominal cavity. Although portal hypertension is the primary cause of ascites, decreased serum proteins and increased aldosterone also contribute to the fluid accumulation. Hypoalbuminemia (low serum albumin) decreases the colloidal osmotic pressure of plasma. This pressure normally holds fluid in the intravascular compartment, but when the plasma colloidal osmotic pressure decreases, fluid escapes into extravascular compartments. Hyperaldosteronism (an increase in aldosterone) causes sodium and water retention, contributing to ascites and generalized edema.
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