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 D

Explanation

A) Decrease folic acid intake: Decreasing folic acid intake is not advisable for clients with malabsorption syndrome. In fact, clients with malabsorption often require increased folic acid due to poor absorption of nutrients, especially in conditions like celiac disease or other causes of malabsorption.

B) Increase lactose intake: Increasing lactose intake is not appropriate for clients with malabsorption syndrome, particularly if they have lactose intolerance. Lactose can exacerbate symptoms such as diarrhea and steatorrhea in these clients.

C) Provide a gluten-free diet: A gluten-free diet is crucial for clients with celiac disease, which is a type of malabsorption syndrome. However, if the malabsorption syndrome is due to another cause, a gluten-free diet might not address the issue. The focus should be on managing fat intake to reduce steatorrhea.

D) Provide a low-fat diet: A low-fat diet is the most appropriate intervention for managing severe steatorrhea, which is the presence of excess fat in the stool. Reducing fat intake helps to minimize fat malabsorption and the associated symptoms, providing relief from steatorrhea.

A. Ibuprofen B. Tramadol C. Ketorolac D. Aspirin

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.

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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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