ANCC Adult–Gerontology Acute Care Nurse Practitioner Certification (AGACNP) Practice Test

Decreased oncotic pressure is often related to low serum protein levels, which can occur in various medical conditions. Chronic liver disease is particularly relevant in this context because the liver plays a critical role in synthesizing albumin, a major protein that maintains oncotic pressure in the bloodstream. When the liver is compromised, as in cirrhosis or severe hepatic dysfunction, the production of albumin decreases significantly, leading to a reduction in oncotic pressure. This can result in transudative pleural effusions as fluid shifts out of the vasculature into the pleural space due to the imbalanced pressures.

In contrast, conditions such as acute pancreatitis may lead to exudative effusions, primarily due to inflammation rather than decreased oncotic pressure. Pneumonia typically causes exudative effusions as well, due to inflammatory mediators increasing vascular permeability. Lastly, a heart attack may lead to congestive heart failure and increased hydrostatic pressure but does not directly impact oncotic pressure in the same way that chronic liver disease does. Understanding the underlying mechanisms of these conditions is essential to accurately predict fluid dynamics and effusion characteristics.