A nurse is caring for a client who has right-sided heart failure. The nurse should assess the client for which of the following manifestations?

Decreased urinary output

Cool extremities

Peripheral edema

Crackles in the lung fields

Answer and Explanation

The Correct Answer is C

A. Decreased urinary output: Decreased urinary output can occur in heart failure due to reduced kidney perfusion, but it is more commonly associated with left-sided heart failure as it leads to fluid congestion in the lungs and a decreased ability of the kidneys to function effectively.

B. Cool extremities: Cool extremities can occur in heart failure, but they are more commonly seen in left-sided heart failure due to poor circulation from the left ventricle. Right-sided heart failure primarily affects the systemic circulation.

C. Peripheral edema: Peripheral edema is a hallmark sign of right-sided heart failure. The right side of the heart is unable to pump blood efficiently to the lungs, causing blood to back up into the veins and resulting in fluid retention in the lower extremities and other parts of the body.

D. Crackles in the lung fields: Crackles in the lung fields are a characteristic finding in left-sided heart failure, as fluid backs up into the lungs. This is not typically a finding associated with right-sided heart failure, which affects the systemic circulation.

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Correct Answer is D

Explanation

A. Perform the reconciliation only at admission and discharge: Medication reconciliation should be performed at all stages of care. It should also be done during transfers between units and at any point where medication changes occur to ensure accuracy and prevent errors.

B. Compare only the prescribed home medications to the new prescriptions: Medication reconciliation requires comparing home medications and any newly prescribed medications. This includes reviewing all medications to identify discrepancies and ensure safety.

C. Delete new prescriptions that may interact with home medications: The nurse should not delete prescriptions. Instead, they should identify potential drug interactions, assess the risks, and notify the healthcare provider to discuss alternatives or adjustments as needed.

D. Consider the risk for medication interactions: The nurse should evaluate the potential for drug interactions by comparing home medications with new prescriptions. This helps to ensure the safety and effectiveness of the client's medication regimen.

A. Hypotension B. Bradycardia C. Bradypnea D. Pruritus

Correct Answer is C

Explanation

A. Hypotension: While hypotension can be a concern with opioid use, it is less immediately life-threatening compared to respiratory depression, which is the most dangerous side effect of morphine. Monitoring BP is important, but the priority is airway and breathing.

B. Bradycardia: Bradycardia is a possible side effect of morphine, but it does not usually present an immediate risk to the client's life unless it is severe. Respiratory depression poses a greater risk to the client’s oxygenation status.

C. Bradypnea: Bradypnea (slow breathing) is the most critical concern when a client is receiving morphine. Opioids like morphine can cause respiratory depression, which can be life-threatening. This should be the nurse's priority to assess and address immediately.

D. Pruritus: Pruritus (itching) is a common side effect of morphine, but it is not life-threatening. While it can be uncomfortable, it does not require immediate intervention compared to respiratory depression.

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A nurse is caring for a client who has right-sided heart failure. The nurse should assess the client for which of the following manifestations?

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