The risk of hypovolemic shock is high with acute mesenteric arterial insufficiency because:
a. the resulting liver failure causes a deficit of plasma proteins and a loss of oncotic pressure.
b. ischemia alters mucosal membrane permeability, and fluid loss occurs.
c. massive bleeding occurs in the GI tract.
d. overstimulation of the parasympathetic nervous system results in ischemic injury to the intestinal wall.
ANS: B
Ischemia and necrosis (intestinal infarction) alter membrane permeability. Initially, there is in-creased motility, nausea, and vomiting. Mucosal alteration causes fluid to move from the blood vessels into the bowel wall and peritoneum. Fluid loss causes hypovolemia. Arterial insufficiency is not related to liver failure. Bleeding may occur, but hypovolemia is related to fluid shifts. Fluid shifts lead to hypovolemia; it is not due to overstimulation of the parasympathetic nerves.
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