Critical Thinking ??? or not??

RNDave · Feb 21, 2006

In normal circulating blood proteins are too large to escape the capillaries, but during stasis( body non-movement) the proteins begin leaking into the interstital fluids causing edema. Why is it that during stasis edema occurs?...snip
I answered: During stasis over long periods of time tissue can be damaged causing tissue injury leading to inflammation. When inflammed and tissues begin to repair vasodilation occurs and capillaries permeability increases, thus allows materials to more easily escape the capillaries and migrate to the siteof the damage.

Since no one seems to be replying, I'll give this a shot (eventhough I'm not much further along than you in my nursing education). My answer would be: Stasis causes increased hydrostatic pressure forcing plasma proteins from capillaries into the interstitium. I think your answer is pretty good, especially if you haven't had pathophysiology yet.

Dave

rhapsodyRN · Feb 22, 2006

We haven't had a lot of essay questions, but yes, this is the format you should get used to and try to love. :) Nursing school tests are geared towards NCLEX-type questions and NCLEX-type questions are all critical thinking. By the time you take the NCLEX you won't know how to NOT think critically anymore..LOL!

If you study by memorizing everything, start NOW getting out of that habit, and start really understanding WHAT stuff does and WHY it does it, not just that it does it. Does that make sense? :)

Race Mom, ASN, RN · Feb 22, 2006

I may be wrong, but here's my thoughts.

Your muscles (and a few other things like one way valves) help give the blood momentum to move back up into the heart (via veins). When you're not moving, your not moving those muscles, therefore your muscles are not helping with the force that is needed to get that fluid back up towards the heart.

Daytonite, BSN, RN · Feb 22, 2006

This is a fluid and electrolyte question. Your answer, inflammation, is correct and reflects critical thinking on your part. Let me carry the thinking a little further for you so you can see the link to nursing. In stasis situations, plain old venous obstruction due to sluggish, pooling blood is usually the culprit. This is one reason why we keep bed-ridden patients turned and moved as much as we can. This is also why it's not good to have a wheel chair patient left sitting for hours at a time with their legs bent at the knee, restricting blood flow to their lower legs and feet, dependent and immobile. These situations increase the hydrostatic pressure of fluid within the capillaries of the lower legs. Remaining in one position for a long period of time, particularly where the lower extremities are in a dependent, or a static position, results in increased hydrostatic pressure in those areas that results in edema. A thrombophlebitis, usually brought about by a blood clot that causes an inflammation of a blood vessel in the lower extremity, can result. Now, your inflammation scenario is complete. The patient's symptoms will be pain, redness, swelling and warmth in the affected leg--the cardinal signs of an inflammation. As protein molecules begin to escape into the interstitial spaces, the blood plasma loses its ability to pull water back out from the interstitial space. The proteins are now exerting enough oncotic pressure on the interstitial side of the capillary membrane to continue pulling more fluid into the interstitial spaces resulting in increasing edema. At this point, nursing interventions will be initiated. But, that is for you to learn in your nursing classes.

The role of plasma in the blood is important in exerting oncotic pressure that helps to regulate fluids passing between the blood and the interstitial spaces. When a situation in the physiology causes a severe decrease in circulating plasma protein, such as in some renal diseases, a type of global edema occurs throughout the entire body due to the inability of the circulating blood to hold onto fluids. So, in diseases like nephrotic syndrome there will be huge losses of protein through the urine resulting in decreased oncotic pressure in the circulating blood that results in sodium and water retention in the interstitial tissues manifested as a generalized body edema (dropsy).

WannaBRN4 · Feb 22, 2006

WOW, Daytonit

That was awesome. thanks a lot for all that information. I guess I will get there soon ebough,but that was great. I got my test back and you were right it was F&E and though we are not that informed we had enough info to infer what would happen along those lines. I got it half correct and that makes me happy. I was 1 of 2 in the class to get it right. It was Extra Credit and prof. was very proud of me for not leaving it blank like everyone else. Thanksagain your answer was more than helpful.