Which diagnostic test will be most useful to the nurse in determining whether a client admitted with acute shortness of breath has heart failure?
Serum troponin
Arterial blood gasses
12-lead electrocardiogram
B-type natriuretic peptide
The Correct Answer is D
B-type natriuretic peptide (BNP) is a diagnostic blood test that can be most useful to the nurse in determining whether a client admitted with acute shortness of breath has heart failure.
BNP is a hormone produced by the heart in response to increased pressure and volume in the heart, especially in cases of heart failure. When the heart is under stress, such as in heart failure, it releases BNP into the bloodstream. Elevated levels of BNP are strongly indicative of heart failure, and the test is particularly helpful in differentiating heart failure from other conditions that may present with similar symptoms, such as pulmonary disorders.
When a patient presents with acute shortness of breath, the BNP test can provide valuable information to help guide the diagnosis and treatment. If the BNP level is elevated, it suggests that heart failure is likely the cause of the symptoms, and appropriate interventions can be initiated promptly.
While other diagnostic tests like serum troponin (A) are important for assessing heart damage in conditions like myocardial infarction (heart attack), they may not be as specific for heart failure.
Arterial blood gases (B) are helpful in evaluating gas exchange and acid-base balance, especially in patients with respiratory distress, but they are not specific for diagnosing heart failure.
A 12-lead electrocardiogram (ECG) (C) can provide valuable information about the heart's electrical activity and any signs of acute myocardial infarction or other cardiac abnormalities, but it is not the primary test for diagnosing heart failure. An ECG can support the diagnosis if specific changes suggestive of heart failure are present, but the BNP test provides more direct evidence for heart failure diagnosis.
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Related Questions
Correct Answer is B
Explanation
The assessment findings of jugular venous distention, weight gain, peripheral edema, and a heart rate of 108/minute are consistent with right-sided heart failure (HF). Right-sided HF occurs when the right ventricle of the heart is unable to pump effectively, leading to congestion in the venous circulation. This can result in jugular venous distention (JVD) due to increased pressure in the jugular veins, peripheral edema due to fluid retention, and weight gain due to fluid accumulation.
Option A (Left-sided HF) may also present with similar symptoms like jugular venous distention, weight gain, and peripheral edema. However, in left-sided HF, there would typically be signs of pulmonary congestion, such as crackles in the lungs and shortness of breath.
Option C (Chronic heart failure) is a general term used for heart failure that has been present for an extended period, and it does not specify whether it is left-sided or right-sided heart failure.
Option D (Acute decompensated heart failure - ADHF) is a form of heart failure that presents with severe symptoms and requires urgent treatment. It is more of a clinical classification rather than a specific complication related to the symptoms mentioned in the scenario.
Correct Answer is A
Explanation
In a client with chronic kidney disease (CKD), metabolic acidosis is a common acid-base disorder due to impaired excretion of acid and decreased bicarbonate reabsorption in the kidneys. The arterial blood gas values associated with metabolic acidosis in CKD are a low pH (acidemia), low bicarbonate (HCO3-), and normal or low partial pressure of carbon dioxide (PaCO2). Option A fits this pattern, with a pH of 7.25 (acidic), HCO3- of 19 mEq/L (low), and a PaCO2 of 30 mm Hg (within the normal to low range).
Option B shows a pH of 7.30 (acidic) but with a higher bicarbonate level of 26 mEq/L, which is not consistent with metabolic acidosis. The elevated bicarbonate level suggests metabolic alkalosis, which is not expected in a client with CKD.
Option C has a pH of 7.50 (alkaline) with an elevated bicarbonate level of 20 mEq/L and a low PaCO2 of 32 mm Hg. This set of values is indicative of metabolic alkalosis, which is not expected in a client with CKD.
Option D has a pH of 7.55 (alkaline) with an elevated bicarbonate level of 30 mEq/L and a low PaCO2 of 31 mm Hg. This set of values is indicative of metabolic alkalosis, which is not expected in a client with CKD.
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