A nurse is caring for a client who had a stroke and has dysphagia. For which of the following complications should the nurse monitor the client?

Choice A reason: Anorexia, or loss of appetite, is not typically a direct manifestation of left-sided heart failure. While it can be associated with many medical conditions and may occur in the context of heart failure due to overall decreased well-being, it is not a specific indicator of left-sided heart failure.

Choice B reason: Weight gain can be associated with heart failure, but it is more commonly a sign of right-sided heart failure, where fluid accumulates in the body tissues, causing swelling and weight increase. In left-sided heart failure, weight gain is not as prominent because the primary issue is the backup of blood into the lungs, not fluid retention in the tissues.

Choice C reason: A distended abdomen can occur in heart failure due to fluid accumulation; however, it is more characteristic of right-sided heart failure, where the failure of the right ventricle leads to systemic congestion, including the abdominal area. In left-sided heart failure, the primary effect is on the lungs, not the abdomen.

Choice D reason: Dyspnea, or difficulty breathing, is a hallmark symptom of left-sided heart failure. It occurs due to the backup of blood in the pulmonary circulation, which leads to pulmonary congestion and reduced oxygen exchange. Patients may experience shortness of breath, especially during exertion or when lying flat (orthopnea), and may wake up at night with shortness of breath (paroxysmal nocturnal dyspnea).

Left-sided heart failure, often caused by conditions like valvular heart disease, leads to a decrease in the heart’s ability to pump blood effectively. This results in a buildup of pressure in the lungs, manifesting as dyspnea, which is an important symptom for nurses and other healthcare providers to recognize and manage promptly.

Choice A reason:Rescheduling the scan is not necessary unless there are other contraindications or scheduling conflicts.

Choice B reason:Sending a suction catheter is a precautionary measure, but it does not address the management of the feeding tube during the scan.

Choice C reason:Shutting off the feeding 30-60 minutes before the scan is a standard practice to reduce the risk of aspiration and to ensure that the stomach contents do not interfere with the imaging.

Choice D reason:Connecting the feeding tube to continuous suction is not typically required unless there is a specific concern for aspiration or gastric content management during the scan.