A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse expect?

Hacking cough

Abdominal distension

Dependent edema

Jugular venous distention

Answer and Explanation

The Correct Answer is A

A. Hacking cough: This is the correct answer. Left-sided heart failure can lead to pulmonary congestion, resulting in a cough that is often described as "hacking" or "persistent." This cough may be worse at night when the client is lying down.

B. Abdominal distension: Abdominal distension is more commonly associated with right-sided heart failure, as fluid accumulates in the abdomen (ascites). In left-sided heart failure, fluid accumulates in the lungs, leading to pulmonary symptoms.

C. Dependent edema: Dependent edema is also more commonly associated with right-sided heart failure. In left-sided heart failure, fluid tends to accumulate in the lungs, causing pulmonary congestion and related symptoms.

D. Jugular venous distention: Jugular venous distention is often seen in right-sided heart failure due to impaired blood flow from the right atrium into the right ventricle. This finding is less likely to be prominent in left-sided heart failure.

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Correct Answer is C

Explanation

A. Administer enteric-coated acetaminophen: Acetaminophen is not typically used to address the symptoms described by the client, such as pain in the jaw, back, and shoulder, shortness of breath, and nausea. Moreover, an enteric-coated form of acetaminophen is not likely to address the acute symptoms.

B. Administer ibuprofen: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) and may not be appropriate for the reported symptoms, especially if they are indicative of a cardiac event.

C. Obtain an EKG: This is the correct answer. The client's symptoms, including pain in the jaw, back, and shoulder, shortness of breath, and nausea, are concerning for a possible cardiac event, such as a myocardial infarction (heart attack). An electrocardiogram (EKG) is a crucial diagnostic tool to assess for cardiac abnormalities and should be done promptly.

D. Maintain oxygen saturations greater than or equal to 92%: While maintaining adequate oxygen saturation is important in various clinical situations, the client's symptoms, especially when associated with potential cardiac issues, warrant an immediate EKG to assess for cardiac abnormalities.

A. Carvedilol B. Captopril C. Isosorbide dinitrate D. Fluticasone

Correct Answer is A

Explanation

A. Carvedilol:Carvedilol is a non-selective beta-blocker that blocks both beta-1 and beta-2 adrenergic receptors. Beta-2 blockade can lead to bronchoconstriction, which can exacerbate asthma symptoms. Clarification is needed to see if a cardioselective beta-blocker (like metoprolol) would be safer.

B. Captopril:Captopril is an ACE inhibitor commonly used in heart failure to reduce blood pressure and decrease the workload on the heart. It does not have bronchoconstrictive effects and is safe for use in clients with asthma.

C. Isosorbide dinitrate:Isosorbide dinitrate is a nitrate used to manage heart failure by dilating blood vessels and reducing the workload of the heart. It has no effect on bronchial smooth muscle and is not contraindicated in asthma, so no clarification is needed.

D. Fluticasone:Fluticasone is an inhaled corticosteroid used to manage asthma by reducing inflammation in the airways. It is beneficial in clients with asthma and does not pose a risk to clients with heart failure. There is no need to clarify this medication.

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A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse expect?

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