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

Weight gain

Warm extremities after walking

Breathlessness when carrying an object

Increased urinary output during the day

Answer and Explanation

The Correct Answer is C

A) Weight gain: Weight gain is more commonly associated with right-sided heart failure due to fluid retention and peripheral edema. While left-sided heart failure can lead to overall heart failure, causing weight gain, it is not as specific as breathlessness for left-sided failure.

B) Warm extremities after walking: Warm extremities are generally a sign of good circulation. In clients with left-sided heart failure, reduced cardiac output often leads to poor peripheral circulation, which would more likely cause cool extremities.

C) Breathlessness when carrying an object: Left-sided heart failure leads to decreased cardiac output and pulmonary congestion. As a result, clients often experience breathlessness or dyspnea, especially during physical activities, because the heart cannot efficiently pump blood, leading to fluid buildup in the lungs.

D) Increased urinary output during the day: Left-sided heart failure usually causes decreased renal perfusion, leading to reduced urinary output during the day. Clients might experience nocturia (increased nighttime urination) due to fluid reabsorption when lying down, but increased daytime output is not typical.

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Correct Answer is B

Explanation

A) Ibuprofen: While ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for pain relief and inflammation, it is not the best choice for a client with a history of peptic ulcer disease. NSAIDs can exacerbate gastrointestinal issues and increase the risk of ulcer complications.

B) Tramadol: Tramadol is a moderate pain reliever that is not an NSAID and does not have the gastrointestinal side effects associated with NSAIDs. It is a suitable choice for short-term pain management in clients with a history of peptic ulcer disease, as it does not increase the risk of ulcer complications.

C) Ketorolac: Ketorolac is a potent NSAID used for short-term pain management. It is not recommended for clients with a history of peptic ulcer disease due to its high risk of causing gastrointestinal bleeding and exacerbating ulcer conditions.

D) Aspirin: Aspirin is an NSAID and has a high potential to irritate the gastrointestinal tract, which can worsen peptic ulcer disease and lead to complications such as bleeding. It is generally avoided in clients with a history of peptic ulcers.

A. "I will remain in the hospital until my treatment is completed." B. "I will wear a surgical mask around my family." C. "I will need medication to treat my condition for the rest of my life." D. "I will need to provide a sputum specimen every 4 weeks until I test negative."

Correct Answer is D

Explanation

A) "I will remain in the hospital until my treatment is completed.": Hospitalization is not typically required for the entire duration of tuberculosis (TB) treatment. Most patients with TB can continue their treatment at home with proper medication and infection control measures, unless they have severe disease or complications.

B) "I will wear a surgical mask around my family.": A surgical mask is not sufficient to protect others from TB. Patients with active TB should wear an N95 respirator mask to reduce the risk of spreading the infection, especially in situations where close contact is unavoidable.

C) "I will need medication to treat my condition for the rest of my life.": TB treatment generally involves a course of medication lasting 6 to 9 months. Long-term, lifelong medication is not required; however, adherence to the full course of prescribed antibiotics is crucial to ensure the infection is fully eradicated.

D) "I will need to provide a sputum specimen every 4 weeks until I test negative.": Monitoring sputum samples every 4 weeks is a standard practice to assess the effectiveness of TB treatment and confirm that the patient is no longer infectious. This statement indicates an understanding of the ongoing evaluation needed during treatment.

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

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