A patient who smokes reports chest pain while at rest.
Which condition would the nurse suspect the patient is experiencing?

Choice A rationale:

Fullness from ascites is a symptom associated with conditions like liver cirrhosis, not directly related to chronic heart failure. Ascites is the accumulation of fluid in the abdominal cavity, causing a feeling of fullness and abdominal discomfort.

Choice B rationale:

Hypoproteinemia, a condition characterized by low levels of proteins in the blood, can lead to fluid retention and edema. However, it is not a direct cause of frequent urination. Frequent urination in this context is more likely related to increased fluid volume in the body, which can be caused by increased renal perfusion in the supine position due to fluid redistribution from the lower extremities to the kidneys.

Choice C rationale:

Hypoperfusion to the brain can lead to neurological symptoms, but it does not directly cause frequent urination. Frequent urination is often related to the kidneys' ability to filter excess fluid and excrete it as urine.

Choice D rationale:

Increased renal perfusion in the supine position can cause frequent urination, especially at night. When a person with chronic heart failure lies down, fluid that has accumulated in the lower extremities (edema) during the day is redistributed to the kidneys due to the change in body position. This increased renal perfusion results in an increased production of urine, leading to nocturia (frequent urination at night) and disrupting the patient's ability to sleep well. This symptom is characteristic of heart failure-related fluid overload and is an important clinical sign indicating worsening heart failure.

Choice A rationale:

A normal blood pressure reading is typically around 120/80 mm Hg. The given reading of 142/91 mm Hg indicates elevated blood pressure.

Choice B rationale:

Prehypertension is defined as systolic blood pressure between 120-139 mm Hg or diastolic blood pressure between 80-89 mm Hg. The diastolic reading of 91 mm Hg places this patient in the stage 1 hypertension category.

Choice D rationale:

Hypertension, stage 2, is characterized by a systolic blood pressure of 140 mm Hg or higher and a diastolic blood pressure of 90 mm Hg or higher. While the systolic reading meets the criteria, the diastolic reading of 91 mm Hg falls into the stage 1 hypertension category.