A patient newly diagnosed with left-sided heart failure is admitted to the hospital. The nurse will observe this patient closely for:

Choice A reason: Use of accessory breathing muscles is a sign of respiratory distress and increased work of breathing. Accessory muscles are the muscles of the neck, chest, and abdomen that assist the diaphragm and intercostal muscles in breathing. They are normally not used for breathing, but they are recruited when the airway is obstructed or the lung function is impaired.

Choice B reason: Foul-smelling sputum is not a sign of an acute asthma episode. It is a sign of a bacterial infection or a lung abscess. Sputum is the mucus that is coughed up from the lungs. It can have different colors, textures, and odors depending on the cause and severity of the condition.

Choice C reason: Feeling of chest tightness is a sign of an acute asthma episode. It is caused by the bronchoconstriction, or the narrowing of the airways, that occurs during an asthma attack. It can also be accompanied by pain or pressure in the chest.

Choice D reason: Coughing is a sign of an acute asthma episode. It is a reflex action that tries to clear the airways of mucus, irritants, or foreign particles. It can also be triggered by the inflammation and hypersensitivity of the airways that occur during an asthma attack.

Choice E reason: Expiratory wheezing is a sign of an acute asthma episode. It is a high-pitched whistling sound that is heard when the person exhales. It is caused by the turbulent flow of air through the narrowed airways. It can also be heard on inspiration, but it is more prominent on expiration.

Choice A reason: This is not the action that the nurse should take. Instructing the patient to monitor weight daily is not relevant to the patient's dizziness. Weight monitoring is more useful for patients with fluid retention or heart failure, which are not caused by calcium channel blockers.

Choice B reason: This is not the action that the nurse should take. Informing the patient to discontinue the medication is not appropriate, as this can cause rebound hypertension and other complications. The patient should not stop taking the medication without consulting their health care provider.

Choice C reason: This is not the action that the nurse should take. Advising the patient to increase dietary sodium is not helpful, as this can worsen the hypertension and increase the risk of cardiovascular events. The patient should follow a low-sodium diet and avoid salt substitutes that contain potassium.

Choice D reason: This is the action that the nurse should take. Encouraging the patient to sit down if feeling faint is a simple and effective way to prevent falls and injuries. Dizziness is a common side effect of calcium channel blockers, especially when the patient changes position or stands up quickly. This is due to the orthostatic hypotension (a drop in blood pressure when standing up) caused by the vasodilation effect of the medication. However, this side effect is usually mild and transient, and can be prevented by rising slowly from a sitting or lying position, drinking plenty of fluids, and avoiding alcohol.