Author Question: What condition may cause a shift to the left of the oxyhemoglobin dissociation curve, resulting in ... (Read 72 times)

fagboi · **on:** Jul 22, 2018

What condition may cause a shift to the left of the oxyhemoglobin dissociation curve, resulting in less oxygen being available to the tissues?

a. massive transfusions of banked blood c. hyperthermia
b. acidosis d. hypoxia

Question 2

The home health nurse teaches the client with chronic lymphedema of the left arm secondary to treatment for breast cancer the importance of removing the intermittent pressure device used for the affected arm at least every 8 hours.

The best rationale for this teaching measure is because this device: 1. Causes pain in the affected extremity, and when removed periodically, the client comfort is promoted.
2. Compresses small vessels, and without periodic removal, tissues nourished by these vessels can break down.
3. Exerts continuous pressure and can cause a rebound effect and lead to more lymphatic fluid if not interrupted.
4. Moves edema from the distal to proximal area of the arm, and periodic removal will increase effectiveness of treatment.

bbburns21 · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

A
A shift to the left may be caused by increased blood pH, hypothermia, or a decrease in the red blood cell enzyme 2, 3-diphosphoglycerate, which may occur after massive transfusions of banked blood. A shift to the right occurs in response to acidosis, hyperthermia, and hypoxia.

Answer to Question 2

2. Compresses small vessels, and without periodic removal, tissues nourished by these vessels can break down.

Rationale:
This device will compromise small vessel circulation, and unless periodically removed, tissues will receive less oxygen and therefore are prone to breakdown. The compression device itself will promote comfort due to movement of edematous fluids from tissues into vessels. There is not a rebound effect from tissue compression itself. Although the movement of edema does flow from distal to proximal, the periodic removal is for the purpose of nourishing tissues fed by small vessels that are compressed when the device is left on continuously.