A 72-year-old female has a history of right heart failure caused by a right ventricular myocardial infarction. Which of the following symptoms are specifically related to her right heart failure?

Choice A reason: Hyperplasia and deformation of bronchial cartilage are not the causes of airway obstruction in COPD type B. Bronchial cartilage is the rigid structure that supports the bronchi, the large airways that branch from the trachea. Hyperplasia is an increase in the number of cells, and deformation is a change in the shape or structure of the cells. These processes can affect the bronchial cartilage, but they do not directly obstruct the airway.

Choice B reason: Loss of alveolar elastin is not the cause of airway obstruction in COPD type B. Alveolar elastin is the elastic fiber that allows the alveoli, the tiny air sacs at the end of the bronchioles, to expand and recoil during breathing. Loss of alveolar elastin is a characteristic of COPD type A (emphysema), which causes the alveoli to lose their shape and collapse. This reduces the surface area for gas exchange, but it does not obstruct the airway.

Choice C reason: Pulmonary edema is not the cause of airway obstruction in COPD type B. Pulmonary edema is the accumulation of fluid in the lungs, usually due to heart failure or lung injury. It causes shortness of breath, coughing, and crackles in the lungs. It can impair gas exchange and oxygenation, but it does not obstruct the airway.

Choice D reason: Thick mucus, fibrosis, and smooth muscle hypertrophy are the causes of airway obstruction in COPD type B. Thick mucus is the result of chronic inflammation and infection of the bronchi, which stimulates the mucus glands to produce more and thicker mucus. Fibrosis is the formation of scar tissue in the bronchial walls, which narrows the airway and reduces its elasticity. Smooth muscle hypertrophy is the enlargement of the smooth muscle cells that surround the bronchi, which increases the airway resistance and causes bronchospasm. These processes combine to obstruct the airway and cause chronic cough, wheezing, and dyspnea.

Choice A reason: ARBs do not affect the LDL cholesterol levels. They lower the blood pressure by blocking the action of angiotensin II, which is a hormone that causes vasoconstriction and sodium retention. Statins are the drugs that lower the LDL cholesterol levels.

Choice B reason: ARBs do not cause weight loss of more than 2 pounds/week. They lower the blood pressure by blocking the action of angiotensin II, which is a hormone that causes vasoconstriction and sodium retention. Diuretics are the drugs that cause weight loss by increasing the urine output and reducing the fluid volume.

Choice C reason: ARBs do not increase the urinary output. They lower the blood pressure by blocking the action of angiotensin II, which is a hormone that causes vasoconstriction and sodium retention. Diuretics are the drugs that increase the urinary output by inhibiting the reabsorption of sodium and water in the kidneys.

Choice D reason: ARBs lower the blood pressure by blocking the action of angiotensin II, which is a hormone that causes vasoconstriction and sodium retention. Therefore, a nursing assessment that confirms that the ARB that a patient is taking is effective is a decrease in the blood pressure. This is the correct statement that describes the expected outcome of ARBs.