Which clinical manifestations would the nurse expect to find during their assessment of a patient with right heart failure (RHF)?

Choice A rationale
Hypocortisolism, also known as Addison’s disease, is characterized by insufficient production of cortisol by the adrenal glands. It does not typically cause goiter, which is an enlargement of the thyroid gland due to various causes such as iodine deficiency, autoimmune diseases, or nodules.
Choice B rationale
Hyperinsulinemia refers to an excess level of insulin in the blood, often associated with insulin resistance and type 2 diabetes. It is not related to the development of goiter.
Choice C rationale
Iodide deficiency is a common cause of goiter. The thyroid gland requires iodine to produce thyroid hormones. When there is a deficiency, the gland enlarges in an attempt to capture more iodine from the bloodstream.
Choice D rationale
Azotemia is an elevation of blood urea nitrogen (BUN) and serum creatinine levels, typically due to kidney dysfunction. It is not associated with the development of goiter.

Choice A rationale
A respiratory rate of 28 breaths per minute indicates tachypnea, which is a sign of respiratory distress. Immediate intervention is needed to address the underlying cause and prevent further deterioration of the patient’s condition.
Choice B rationale
A temperature of 38°C (100.4°F) indicates a fever, which may suggest an infection. While this requires medical attention, it is not as immediately critical as respiratory distress.
Choice C rationale
A blood pressure of 140/90 mmHg is considered high, but it does not indicate an immediate need for intervention in the context of COPD. Hypertension should be managed, but it is not an acute emergency.
Choice D rationale
A heart rate of 90 beats per minute is within the normal range and does not indicate an immediate need for intervention. Monitoring the patient’s heart rate is important, but it is not an urgent concern in this scenario.