A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of left-sided heart failure?

"I have experienced blurred vision on several occasions."

"I must stop halfway up the stairs to catch my breath."

"I have been drinking more water than usual."

"I am awakened by the need to urinate at night."

Answer and Explanation

The Correct Answer is B

A. Blurred vision is not a typical symptom of left-sided heart failure.

B. Difficulty breathing while performing activities, such as climbing stairs, is a classic symptom of left-sided heart failure due to pulmonary congestion.

C. Increased water intake is not directly indicative of left-sided heart failure.

D. Nocturia can occur in heart failure, but it is less specific than dyspnea on exertion.

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Correct Answer is B

Explanation

A. Sucking on small quantities of ice chips is not appropriate in this case as it may worsen the airway obstruction or cause further irritation.

B. Applying oxygen and continuously monitoring the client's pulse oximetry will help ensure that the client's oxygen saturation remains adequate and that they do not experience respiratory distress or hypoxemia due to inhalation injury. Early intervention is crucial to prevent worsening of respiratory status.

C. Humidified room air can help in cases of airway irritation, but the priority is to ensure oxygenation and avoid hypoxia.

D. Antitussive medications may be indicated later, but airway management and oxygenation take precedence.

A. Client who describes intense squeezing pressure across the chest. B. Client who reports moderate pain that is worse on inspiration. C. Client who reports cramping substernal pain. D. Client who describes pain as a dull ache.

Correct Answer is A

Explanation

A. This description is indicative of possible myocardial infarction (MI), a life-threatening emergency. Immediate evaluation and intervention, such as administering oxygen, obtaining an EKG, and providing pain relief, are crucial to prevent further damage to the heart and reduce mortality.

B. Moderate pain worse on inspiration suggests pleuritic pain, often associated with conditions like pleuritis or pulmonary embolism, which are serious but generally not as immediately life-threatening as an MI.

C. Cramping substernal pain may indicate a gastrointestinal issue, such as gastroesophageal reflux disease (GERD), which is less urgent than a potential MI.

D. A dull ache may be related to musculoskeletal or gastrointestinal issues and does not suggest the immediate need for intervention seen in MI.

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A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of left-sided heart failure?

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