A client has been diagnosed with heart failure. One of the main overall objectives of the management of heart failure is which of the following?
Achieve a blood pressure of 120/80
Reduce the workload on the heart
Help the client walk briskly on a treadmill at 4 to 5 miles an hour
Eliminate all sodium and fat from the diet
The Correct Answer is B
Choice A reason : Achieving a blood pressure of 120/80 is a general goal for overall cardiovascular health, but it is not specific to the management of heart failure. While controlling blood pressure is important in heart failure, the primary objective is to reduce the heart's workload¹.
Choice B reason : Reducing the workload on the heart is a key objective in managing heart failure. This can be achieved through medications that improve heart function, lifestyle changes, and sometimes surgical interventions. The goal is to improve the heart's efficiency and reduce symptoms such as shortness of breath and fatigue¹.
Choice C reason : Encouraging the client to walk briskly on a treadmill at 4 to 5 miles an hour may not be appropriate for all heart failure patients, especially without medical supervision. Exercise recommendations should be personalized based on the individual's condition and tolerance¹.
Choice D reason : While dietary modifications are part of heart failure management, completely eliminating all sodium and fat is not practical or recommended. Instead, a balanced diet with controlled sodium intake is advised to help manage fluid retention¹.
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Correct Answer is D
Explanation
Choice A reason : Abdominal distension is more commonly associated with right-sided heart failure due to fluid accumulation in the abdominal cavity. Left-sided heart failure primarily affects the lungs, leading to respiratory symptoms¹.
Choice B reason : Jugular venous distention is typically a sign of right-sided heart failure, indicating increased pressure in the right atrium and venous system. It is not a primary symptom of left-sided heart failure¹.
Choice C reason : Dependent edema, or swelling in the lower extremities, is also more indicative of right-sided heart failure, where fluid accumulates due to poor venous return. In left-sided heart failure, fluid backs up into the lungs rather than the extremities¹.
Choice D reason : A hacking cough, especially when lying down, is a symptom of left-sided heart failure, as fluid backs up into the lungs causing pulmonary congestion. This can lead to coughing and shortness of breath, particularly during exertion or when lying flat¹.
Correct Answer is A
Explanation
Choice A reason : Regular exercise, as tolerated and recommended by a healthcare provider, is beneficial for heart failure patients as it can improve cardiovascular health and overall well-being⁵.
Choice B reason : Taking naproxen sodium for generalized discomfort is not recommended for heart failure patients as nonsteroidal anti-inflammatory drugs (NSAIDs) can worsen heart failure by causing fluid retention and increasing blood pressure⁵.
Choice C reason : Taking diuretics early in the morning is advised to avoid nocturia; however, taking them before bedtime is not recommended for the same reason, as it can disrupt sleep due to the need for frequent urination⁵.
Choice D reason : Patients should be instructed to notify their healthcare provider of a weight gain of 0.5 kg (1 lb) in a week as it may indicate fluid retention, which is a common issue in heart failure⁵.
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