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) Maintain the client on bed rest for 48 hr following surgery: While some bed rest is recommended initially post-surgery, maintaining bed rest for 48 hours is excessive and can increase the risk of complications like deep vein thrombosis. Early mobilization is generally encouraged to enhance recovery.

B) Check the tubing for kinks and blood clots at least every 2 hr: Regularly checking the catheter tubing for kinks and blood clots is essential to ensure the continuous flow of urine and prevent catheter blockage. This can help in reducing the risk of complications such as bladder distension and urinary retention.

C) Irrigate the client's bladder continuously using 5% dextrose in Ringer's lactate: Continuous bladder irrigation is often done post-TURP to prevent clot formation, but 5% dextrose in Ringer's lactate is not the recommended solution. Typically, normal saline is used to minimize the risk of electrolyte imbalance and maintain the correct osmolarity.

D) Remove the catheter if the client reports severe bladder spasms: Severe bladder spasms can occur post-TURP, but removing the catheter is not the immediate solution. The catheter is necessary for drainage and should be managed with antispasmodic medications or adjusting the irrigation flow rather than removal.

A. "Apply dry heat to help the lesions scab over." B. "Take three sitz baths each day to alleviate symptoms." C. "Apply talcum powder to the perineal area to help the lesions dry." D. "You can resume intercourse with the use of natural membrane condoms."

Correct Answer is B

Explanation

A. Apply dry heat to help the lesions scab over.: Applying dry heat is not a recommended treatment for herpes simplex lesions. Moist heat, such as sitz baths, can help alleviate discomfort and promote healing.

B. Take three sitz baths each day to alleviate symptoms.: Sitz baths can help soothe and clean the affected area, providing relief from pain and itching associated with herpes simplex virus lesions. This is an appropriate recommendation for symptom management.

C. Apply talcum powder to the perineal area to help the lesions dry.: Talcum powder is not recommended for herpes simplex lesions as it can irritate the skin and worsen symptoms. Keeping the area dry can be beneficial, but using powders is not advised.

D. You can resume intercourse with the use of natural membrane condoms.: Condoms may reduce the risk of transmission but do not eliminate it completely. It is generally advised to avoid sexual activity during an outbreak to prevent spreading the virus.

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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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