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 A

Explanation

A) Manic behavior: Hyperthyroidism can lead to manic or hyperactive behavior due to increased metabolic rate and overstimulation of the nervous system. This may present as irritability, anxiety, or restlessness, making manic behavior a relevant manifestation in this condition.

B) Deep, labored respirations: Hyperthyroidism generally does not cause deep, labored respirations. Instead, it may lead to increased respiratory rate due to heightened metabolic activity. Deep, labored respirations are more indicative of respiratory or cardiac issues rather than hyperthyroidism.

C) Bradycardia: Hyperthyroidism usually causes tachycardia (elevated heart rate) rather than bradycardia (slow heart rate). Tachycardia is a common symptom due to the increased metabolic rate and sympathetic nervous system activity associated with hyperthyroidism.

D) Cold intolerance: Cold intolerance is more characteristic of hypothyroidism, where there is decreased metabolic activity and reduced heat production. Hyperthyroidism typically causes heat intolerance due to the increased metabolic rate and elevated body temperature.

A. "Use petroleum jelly on a cotton ball to plug your ear when shampooing." B. "Clean dried blood in your ear canal with a cotton-tipped applicator." C. "Avoid blowing your nose for 1 month after surgery." D. "Notify your provider if you have popping or crackling sensations in the affected ear."

Correct Answer is C

Explanation

A) Use petroleum jelly on a cotton ball to plug your ear when shampooing.
This technique helps prevent water from entering the ear during activities like showering. While it is useful for keeping the ear dry, it does not directly address preventing trauma or further hearing impairment post-surgery.

B) Clean dried blood in your ear canal with a cotton-tipped applicator.
Using cotton-tipped applicators can cause damage to the delicate ear canal and potentially disturb the surgical site. This action increases the risk of infection and trauma, potentially worsening hearing loss instead of preventing it.

C) Avoid blowing your nose for 1 month after surgery.
Refraining from nose blowing is essential because it prevents pressure changes that could disrupt the surgical repair. Such pressure changes can lead to complications like graft displacement, which can cause trauma and impair hearing.

D) Notify your provider if you have popping or crackling sensations in the affected ear.
Popping or crackling can be common as the ear heals and adjusts. These sensations typically do not indicate a problem unless accompanied by pain or other symptoms. Thus, while monitoring is important, it is not a primary preventative measure for trauma or hearing issues.

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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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