Nurs. 107 Ch 25 Mgmt of Pts W/Complications From Heart Disease Wkbk & Prep-U Questions

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For cardiopulmonary resuscitation, the recommended chest compression rate is ___________ times/min. The compression to ventilation ratio of __________ is recommended without stopping for ventilation

100; 30:2

The nurse is performing a respiratory assessment for a patient in left-sided heart failure. What does the nurse understand is the best determinant of the patient's ventilation and oxygenation status? A) Arterial blood gases B) End-tidal CO2 C) Listening to breath sounds D) Pulse oximetry

A) Arterial blood gases Explanation: In left-sided heart failure, arterial blood gases may be obtained to assess ventilation and oxygenation.

The nurse assessing a client with an exacerbation of heart failure identifies which symptom as a cerebrovascular manifestation of heart failure (HF)? A) Dizziness B) Ascites C) Tachycardia D) Nocturia

A) Dizziness Explanation: Cerebrovascular manifestations of heart failure stemming from decreased brain perfusion include dizziness, lightheadedness, confusion, restlessness, and anxiety due to decreased oxygenation and blood flow.

The clinical manifestations of cardiogenic shock reflect the pathophysiology of heart failure (HF). By applying this correlation, the nurse notes that the degree of shock is proportional to which of the following? A) Left ventricular function B) Right ventricular function C) Right atrial function D) Left atrial function

A) Left ventricular function Explanation: The signs and symptoms of cardiogenic shock reflect the circular nature of the pathophysiology of HF. The degree of shock is proportional to the extent of left ventricular dysfunction.

The nurse is providing discharge instructions to a client with heart failure preparing to leave the following day. What type of diet should the nurse request the dietitian to discuss with the client? A) Low-cholesterol diet B) Low-fat diet C) Low-sodium diet D) Low-potassium diet

A) Low-sodium diet Explanation: Medical management of both left-sided and right-sided heart failure is directed at reducing the heart's workload and improving cardiac output primarily through dietary modifications, drug therapy, and lifestyle changes. A low-sodium diet is prescribed, and fluids may be restricted. Because the client will be on a diuretic such as Lasix, he may become potassium depleted and would need potassium in the diet. A low-cholesterol and low-fat diet may be ordered but are not specific to the heart failure.

Which nursing intervention should the nurse perform when a client with valvular disorder of the heart has a heart rate less than 60 beats/min before administering beta-blockers? A) Withhold the drug and inform the primary health care provider. B) Check for signs of toxicity. C) Continue the drug and document in the client's chart. D) Observe for symptoms of pulmonary edema.

A) Withhold the drug and inform the primary health care provider. Explanation: Before administering a beta-blocker, the nurse should monitor the client's apical pulse. If the heart rate is less than 60 bpm, the nurse should withhold the drug and inform the primary health care provider.

When a client has increased difficulty breathing when lying flat, the nurse records that the client is demonstrating: A) orthopnea. B) hyperpnea. C) paroxysmal nocturnal dyspnea. D) dyspnea upon exertion.

A) orthopnea. Explanation: Clients with orthopnea prefer not to lie flat and will need to maintain their beds in a semi- to high Fowler position. Dyspnea upon exertion refers to difficulty breathing with activity. Hyperpnea refers to increased rate and depth of respiration. Paroxysmal nocturnal dyspnea refers to orthopnea that occurs only at night.

A client with a history of an anterior wall myocardial infarction is being transferred from the coronary care unit (CCU) to the cardiac step-down unit (CSU). While giving a report to the CSU nurse, the CCU nurse says, "His pulmonary artery wedge pressures have been in the high normal range." What additional assessment information would be important for the CSU nurse to obtain? A) pulmonary crackles B) high urine output C) dry mucous membranes D) hypertension

A) pulmonary crackles Explanation: High pulmonary artery wedge pressures are diagnostic for left-sided heart failure. With left-sided heart failure, pulmonary edema can develop causing pulmonary crackles. In left-sided heart failure, hypotension may result and urine output will decline. Dry mucous membranes aren't directly associated with elevated pulmonary artery wedge pressures.

Four types of drugs normally prescribed for systolic heart failure:

Angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, diuretics, digitalis

Which diagnostic study is usually performed to confirm the diagnosis of heart failure? A) Serum electrolytes B) Echocardiogram C) Blood urea nitrogen (BUN) D) Electrocardiogram (ECG)

B) Echocardiogram Explanation: An echocardiogram is usually performed to confirm the diagnosis of heart failure. ECG, serum electrolytes, and a BUN are usually completed during the initial workup.

Which feature is the hallmark of systolic heart failure? A) Limited activities of daily living (ADLs) B) Low ejection fraction (EF) C) Pulmonary congestion D) Basilar crackles

B) Low ejection fraction (EF) Explanation: A low EF is a hallmark of systolic heart failure (HF); the severity of HF is frequently classified according to the client's symptoms.

While auscultating the heart sounds of a client with heart failure, the nurse hears an extra heart sound immediately after the second heart sound (S2). How should the nurse document this sound? A) a third heart sound (S3). B) a fourth heart sound (S4). C) a murmur. D) a first heart sound (S1).

B) a third heart sound (S3). Explanation: An S3 is heard following an S2, which commonly occurs in clients experiencing heart failure and results from increased filling pressures. An S1 is a normal heart sound made by the closing of the mitral and tricuspid valves. An S4 is heard before an S1 and is caused by resistance to ventricular filling. A murmur is heard when there is turbulent blood flow across the valves.

The nurse is assessing a client with crackling breath sounds or pulmonary congestion. What is the cause of the congestion? A) nocturia B) inadequate cardiac output C) hepatomegaly D) ascites

B) inadequate cardiac output Explanation: Pulmonary congestion occurs and tissue perfusion is compromised and diminished when the heart, primarily the left ventricle, cannot pump blood out of the ventricle effectively into the aorta and the systemic circulation. Ascites is fluid in the abdomen, not a cause of congestion. Hepatomegaly is an enlarged liver, which does not cause crackling breath sounds. Nocturia, or voiding at night, does not cause crackling breath sounds.

The nurse is administering digoxin to a client with heart failure. What laboratory value may predispose the client to digoxin toxicity? A) magnesium level of 2.5 mg/dL B) potassium level of 2.8 mEq/L C) sodium level of 152 mEq/L D) calcium level of 7.5 mg/dL

B) potassium level of 2.8 mEq/L Explanation: Conditions that may predispose a client to digoxin toxicity include hypokalemia (evidenced by a potassium level less than 3.5 mEq/L), hypomagnesemia (evidenced by a magnesium level less than 1.5 mEq/L), hypothyroidism, hypoxemia, advanced myocardial disease, active myocardial ischemia, and altered autonomic tone. Hypermagnesemia (evidenced by a magnesium level greater than 2.5 mEq/L), hypercalcemia (evidenced by an ionized calcium level greater than 5.3 mg/dl), and hypernatremia (evidenced by a sodium level greater than 145 mEq/L) aren't associated with a risk of digoxin toxicity.

A client with chronic heart failure is receiving digoxin 0.25 mg by mouth daily and furosemide 20 mg by mouth twice daily. The nurse should assess the client for what sign of digoxin toxicity? A) nocturia and sleep disturbances. B) visual disturbances. C) dry mouth and urine retention. D) taste and smell alterations.

B) visual disturbances. Explanation: Digoxin toxicity may cause visual disturbances (e.g., flickering flashes of light, colored or halo vision, photophobia, blurring, diplopia, and scotomata), central nervous system abnormalities (e.g., headache, fatigue, lethargy, depression, irritability and, if profound, seizures, delusions, hallucinations, and memory loss), and cardiovascular abnormalities (e.g., abnormal heart rate, arrhythmias). Digoxin toxicity doesn't cause taste and smell alterations. Dry mouth and urine retention typically occur with anticholinergic agents, not inotropic agents such as digoxin. Nocturia and sleep disturbances are adverse effects of furosemide — especially if the client takes the second daily dose in the evening, which may cause diuresis at night.

CASE STUDY: Mr. Wolman also takes furosemide (40 mg) twice a day. What foods should the nurse suggest that would be a supplement for potassium?

Banans, raisins, and orange juice

The nurse is admitting a client with heart failure. What client statement indicates that fluid overload was occurring at home? A) "My best time of the day is the morning." B) "I've stopped eating foods with salt, though I miss the taste." C) "I'm having trouble going up the steps during the day." D) "I eat six small meals a day when I am hungry."

C) "I'm having trouble going up the steps during the day." Explanation: Difficulty with activities like climbing stairs is an indication of a lessened ability to exercise. Eating small meals and not using salt are usually indicated for clients with heart failure. The client's assertion about morning being the best time of day is a vague statement.

A patient in severe pulmonary edema is being intubated by the respiratory therapist. What priority action by the nurse will assist in the confirmation of tube placement in the proper position in the trachea? A) Observe for mist in the endotracheal tube. B) Listen for breath sounds over the epigastrium. C) Call for a chest x-ray. D) Attach a pulse oximeter probe and obtain values.

C) Call for a chest x-ray. Explanation: A chest x-ray is always obtained after ET tube placement to confirm that the tube is in the proper position within the trachea.

A client is admitted to the hospital with systolic left-sided heart failure. The nurse knows to look for which assessment finding for this client? A) Pedal edema B) Nausea C) Pulmonary congestion D) Jugular venous distention

C) Pulmonary congestion Explanation: When the left ventricle cannot effectively pump blood out of the ventricle into the aorta, the blood backs up into the pulmonary system and causes congestion, dyspnea, and shortness of breath. All the other choices are symptoms of right-sided heart failure. They are all symptoms of systolic failure.

A client asks the nurse if systolic heart failure will affect any other body function. What body system response correlates with systolic heart failure (HF)? A) increased blood volume ejected from ventricle B) dehydration C) decrease in renal perfusion D) vasodilation of skin

C) decrease in renal perfusion Explanation: A decrease in renal perfusion due to low cardiac output (CO) and vasoconstriction causes the release of renin by the kidney. Systolic HF results in decreased blood volume being ejected from the ventricle. Sympathetic stimulation causes vasoconstriction of the skin, gastrointestinal tract, and kidneys. Dehydration does not correlate with systolic heart failure.

The nurse is admitting a client with frothy pink sputum. What does the nurse suspect is the primary underlying disorder of pulmonary edema? A) decreased right ventricular elasticity B) increased right atrial resistance C) decreased left ventricular pumping D) increased left atrial contractility

C) decreased left ventricular pumping Explanation: Pulmonary edema is an acute event that results from heart failure. Myocardial scarring, resulting from ischemia, limits the distensibility of the ventricle, making it vulnerable to demands for increased workload. When the demand on the heart increases, there is resistance to left ventricular filling and blood backs up into the pulmonary circulation. Pulmonary edema quickly develops.

The nurse is caring for a client with advanced heart failure. What treatment will be considered after all other therapies have failed? A) cardiac resynchronization therapy B) implantable cardiac defibrillator (ICD) C) heart transplant D) ventricular access device

C) heart transplant Explanation: Heart transplantation involves replacing a person's diseased heart with a donor heart. This is an option for advanced HF patients when all other therapies have failed. A ventricular access device, ICD, and cardiac resynchronization therapy would be tried prior to a heart transplant.

A nurse suspects that a client has digoxin toxicity. The nurse should assess for: A) hearing loss. B) decreased urine output. C) vision changes. D) gait instability.

C) vision changes. Explanation: Vision changes, such as halos around objects, are signs of digoxin toxicity. Hearing loss can be detected through hearing assessment; however, it isn't a common sign of digoxin toxicity. Intake and output aren't affected unless there is nephrotoxicity, which is uncommon. Gait changes are also uncommon.

Which medication reverses digitalis toxicity? A) Ibuprofen B) Amlodipine C) Warfarin D) Digoxin immune FAB

D) Digoxin immune FAB Explanation: Digoxin immune FAB binds with digoxin and makes it unavailable for use. The dosage is based on the digoxin concentration and the client's weight. Ibuprofen, warfarin, and amlodipine are not used to reverse the effects of digoxin.

The nurse is teaching a client about lifestyle modifications after a heart failure diagnosis. What will be included in the teaching? A) Drink 3 liters of fluid per day. B) Restrict dietary potassium. C) Avoid any alcohol. D) Engage in exercise daily.

D) Engage in exercise daily. Explanation: Lifestyle recommendations after heart failure include restriction of dietary sodium; avoidance of excessive fluid intake, excessive alcohol intake, and smoking; weight reduction when indicated; and regular exercise. The restriction of potassium is not required. Drinking 3 liters of fluid per day would be excessive for a client with heart failure.

A client with acute pericarditis is exhibiting distended jugular veins, tachycardia, tachypnea, and muffled heart sounds. The nurse recognizes these as symptoms of what occurrence? A) The parietal and visceral pericardial membranes adhere to each other, preventing normal myocardial contraction. B) Fibrin accumulation on the visceral pericardium infiltrates into the myocardium, creating generalized myocardial dysfunction. C) The pericardial space is eliminated with scar tissue and thickened pericardium. D) Excess pericardial fluid compresses the heart and prevents adequate diastolic filling.

D) Excess pericardial fluid compresses the heart and prevents adequate diastolic filling. Explanation: The cardinal signs of cardiac tamponade are falling systolic blood pressure, narrowing pulse pressure, rising venous pressure (increased JVD), and distant (muffled) heart sounds. Increased pericardial pressure, reduced venous return to the heart, and decreased carbon dioxide result in cardiac tamponade (e.g., compression of the heart).

A client with congestive heart failure is admitted to the hospital after reporting shortness of breath. How should the nurse position the client in order to decrease preload? A) Head of the bed elevated 30 degrees and legs elevated on pillows B) Prone with legs elevated on pillows C) Supine with arms elevated on pillows above the level of the heart D) Head of the bed elevated 45 degrees and lower arms supported by pillows

D) Head of the bed elevated 45 degrees and lower arms supported by pillows Explanation: Preload refers to the degree of stretch of the ventricular cardiac muscle fibers at the end of diastole. The client is positioned or taught how to assume a position that facilitates breathing. The number of pillows may be increased, the head of the bed may be elevated, or the client may sit in a recliner. In these positions, the venous return to the heart (preload) is reduced, pulmonary congestion is alleviated, and pressure on the diaphragm is minimized. The lower arms are supported with pillows

The nurse instructs a client with heart failure on restricting sodium in the diet. Which client statement indicates that teaching was effective? A) "I will add a water softener to my water at home." B) "Canned vegetables have low sodium content." C) "Lemon juice and herbs can be used to replace salt when cooking." D) "Food prepared at home is saltless unless I add it while cooking."

D) Lemon juice and herbs can be used to replace salt when cooking." Explanation: For the client on a low-sodium or sodium-restricted diet, a variety of flavorings, such as lemon juice, vinegar, and herbs, may be used to improve the taste of the food and facilitate acceptance of the diet. Sodium is contained in municipal water. Water softeners also increase the sodium content of drinking water. Although the major source of sodium in the average American diet is salt, many types of natural foods contain varying amounts of sodium. Even if no salt is added in cooking and if salty foods are avoided, the daily diet will still contain about 2000 mg of sodium. Fresh fruits and vegetables are low in sodium and should be encouraged.

A client is admitted to the ICU with a diagnosis of heart failure. The client is exhibiting symptoms of weakness, ascites, weight gain, and jugular vein distention. The nurse would know that the client is exhibiting signs of what kind of heart failure? A) Left-sided heart failure B) Chronic heart failure C) Acute heart failure D) Right-sided heart failure

D) Right-sided heart failure Explanation: Signs and symptoms of Right Ventricular Failure include: Weakness; Ascites; Weight gain; Nausea, vomiting; Dysrhythmias; Elevated central venous pressure; Jugular vein distention. The scenario does not indicate whether the heart failure is chronic or acute. Therefore, options A, B, and C are incorrect.

A client with a history of heart failure is returning from the operating room after inguinal hernia repair and the nurse assesses a low pulse oximetry reading. What is the most important nursing intervention? A) Assess the surgical incisional area. B) Assess for jugular vein distention. C) Administer pain medication. D) Titrate oxygen therapy.

D) Titrate oxygen therapy. Explanation: The nurse needs to titrate oxygen therapy to increase the client's oxygen levels. Assessing for jugular vein distention and examining the surgical incision area will not meet the oxygen demands. Administering pain medication will not increase oxygenation levels.

A client who has developed congestive heart failure must learn to make dietary adaptations. The client should avoid: A) angel food cake. B) dried peas. C) ready-to-eat cereals. D) canned peas.

D) canned peas. Explanation: There is a wide variety of foods that the client can still eat; the key is to have low-salt content. Canned vegetables are usually very high in salt or sodium, unless they have labels such as low-salt or sodium free or salt free. It is important to read food labels and look for foods that contain less than 300 mg sodium/serving.

Identify six causes of cardiogenic shock:

End-stage heart, cardiac tamponade, pulmonary embolism, cardiomyopathy, myocardial ischemia, and dysrhythmias

Compare and contrast preload and afterload

Preload is the amount of myocardial stretch created by the volume of blood within the ventricle before systole. Afterload refers to the amount of resistance to the ejection of the blood from the ventricle

CASE STUDY: Mr. Wolman is to be discharged from the hospital to home. He is 79 years old, lives with his wife, and has just recovered from mild pulmonary edema secondary to CHF. What would the rationale be for the nurse advising Mr. Wolman to rest frequently at home?

Rest decreases blood pressure, increases the heart reserve, and reduces the work of the heart

What four common side effects of diuretics should the nurse discuss with a patient?

Symptomatic hypotension, hyperuricemia, otoxicity, electrolyte imbalances, dizziness, and balance problems

CASE STUDY: Mr. Wolman will be discharged with a prescription of digoxin 0.25 mg once daily. What education should the nurse include regarding symptoms of toxicity?

Symptoms of toxicity include anorexia, bradycardia and tachycardia, N/V,. Mr. Wolman should call his doctor if any of these symptoms occur

CASE STUDY: What position should the nurse inform the patient to sleep in when he goes home? Why?

The patient should maintain an upright position wiht the feet and legs dependent to reduce left ventricular workload

Two factors that determine preload are:

Venous return and ventricular compliance

What six symptoms does the nurse recognize are indicative of hypokalemia?

Weak pulse, faint heart sounds, hypotension, muscle flabbiness, diminished deep tendon reflexes, and generalized weakness

cardiac resynchronization therapy (CRT)

a treatment for heart failure in which a device paces both ventricles to synchronize contractions

The nurse is assigned to care for a patient with heart failure. What classification of medication does the nurse anticipate administering that will improve symptoms as well as increase survival? a. Angiotensin-converting enzyme inhibitor (ACE) b. Calcium channel blocker c. Diuretic d. Bile acid sequestrants

a. Angiotensin-converting enzyme inhibitor (ACE)

The nurse is preparing to administer hydrlazine and isosorbide dinitrate. When obtaining vital signs, teh nurse notes that the blood pressure is 90/60 mm Hg. What is the priority action by the nurse? a. Hold the medication and call the health care provider b. Administer the medication and check the blood pressure in 30 minutes c. Administer a saline bolus of 250 mL and then administer the medication d. Administer the hydralazine and hold the isosorbide dinitrate

a. Hold the medication and call the health care provider

A patient seen in the clinic has been diagnosed with stage A heart failure (according to the staging classification of the American College of Cardiology [ACC]). What education will the nurse provide to this patient? a. Information about ACE inhibitors and risk factor reduction b. Information about diuretic therapy and risk factor reduction c. Information about beta blockers, ACE inhibitors, and diuretics d. Information about implantable cardioverter/defibrillators

a. Information about ACE inhibitors and risk factor reduction

A patient taking an ACE inhibitor has developed a dry, hacking cough. Because of this side effect, the patient no longer wants to take that medication. What medication that has similar hemodynamic effects does the nurse anticipate the physician prescribing? a. Valsartan b. Furosemide c. Metoprolol d. Isosorbide dinitrate

a. Valsartan

A patient has been experiencing increasing shortness of breath and fatigue. The health care provider has prescribed a diagnostic test in order to determine what type of heart failure the patient is having. What diagnostic test does the nurse anticipate preparing the patient for? a. A chest x-ray b. An echocardiogram c. An electrocardiogram d. A ventriculogram

b. An echocardiogram

The nurse is assessing a patient who reports no symptoms of heart failure at rest but is symptomatic with increased physical activity. Under what classification does the nurse understand this patient would be categorized? a. I b. II c. III d. IV

b. II

A patient in cardiogenic shock after a myocardial infarction is placed on an intra-aortic balloon pump. What is the mechanism of action of the balloon pump? a. The balloon keeps the vessels open so that blood will adequately deliver to the myocardium b. The balloon inflates at the beginning of diastole and deflates before systole to augment the pumping action of the heart c. The balloon delivers an electrical impulse to correct dysrhythmias the patient experiences d. The balloon will inflate at the beginning of systole and deflate before diastole to provide a long-term solution to a failing myocardium

b. The balloon inflates at the beginning of diastole and deflates before systole to augment the pumping action of the heart

The health care provider writes orders for a patient to receive an angiotensin II receptor blocker for treatment of heart failure. What medication does the nurse administer? a. Digoxin b. Valsartan c. Metolazone d. Carvedilol

b. Valsartan

A patient has missed two doses of digitalis. What laboratory results would indicate to the nurse that the patient is within therapeutic range? a. 0.25 mg/mL b. 4.0 mg/mL c. 2.0 mg/mL d. 3.2 mg/mL

c. 2.0 mg/mL

A patient is seen in the emergency department with heart failure secondary to dilated cardiomyopathy. What key diagnostic test does the nurse assess to determine the severity of the patient's heart failure? a. Blood urea nitrogen (BUN) b. Complete Blood Count (CBC) c. B-type natriuretic peptide (BNP) d. Serum electrolytes

c. B-type natriuretic peptide (BNP)

A patient in severe pulmonary edema is being intubated by the respiratory therapist. What priority action by the nurse will assist in the confirmation of the tube placement in the proper position in the trachea? a. Observe for mist in the endotracheal tube b. Listen for breath sounds over the epigastrium c. Call for a chest x-ray d. Attach a pulse oximeter probe and obtain values

c. Call for a chest x-ray

A patient is admitted to the ICU with left-sided heart failure. What clinical manifestations does the nurse anticipate finding when performing an assessment? (Select all that apply) a. Jugular vein distention b. Ascites c. Pulmonary crackles d. Dyspnea e. Cough

c. Pulmonary crackles d. Dyspnea e. Cough

pulseless electrical activity (PEA)

condition in which electrical activity is present on an electrocardiogram, but there is not an adequate pulse or blood pressure

Four common etiologic factors that cause myocardial dysfunction include:

coronary artery disease, cardiomyopathy, hypertension, valvular disorders

The nurse observes that a patient has 2+ pitting edema in the lower extremities. What does this indicate to the nurse regarding fluid retention? a. A weight gain of 4 lbs b. A weight gain of 6 lbs c. A weight gain of 8 lbs d. A weight gain of 10 lbs

d. A weight gain of 10 lbs

The nurse is performing a respiratory assessment for a patient in left-sided heart failure. What is the best determinant of the patient's ventilation and oxygenation status? a. Pulse oximetry b. Listening to breath sounds c. End-tidal CO2 d. Arterial blood gases

d. Arterial blood gases

The nurse hears the alarm sound on the telemetry monitor and observes a flat line. The patient is found unresponsive, without a pulse, and no respiratory effort. What is the first action by the nurse? a. Administer epinephrine 1:10,000 10 mL IV push b. Deliver breaths with a bag-valve mask c. Defibrillate the patient with 360 J d. Call for help and begin chest compressions

d. Call for help and begin chest compressions

The primary systemic clinical manifestations of right-sided failure are:

dependent edema, hepatomegaly, ascites, anorexia, nausea, weakness, weight gain (fluid retention)

Name three types of cardiomyopathy: Which is most common?

dilated, hypertrophic, restrictive; dilated

The primary clinical manifestations of pulmonary congestion in left-sided heart failure are: and a probable:

dyspnea, cough, pulmonary crackles, low oxygen saturation, extra heart sound (ventricular gallop)

Coronary atherosclerosis results in tissue ischemia, which causes myocardial dysfunction, because: result from:

hypoxia, acidosis, the accumulation of lactic acid

Three noninvasive tests are used to assess cardiac hemodynamics: (__________) for right ventricular period (_________) for the left ventricular afterload, and (________) for left ventricular preload

jugular venous distention, mean arterial blood pressure, and a positive hepatojugular test

Cough that may be blood tinged (associated pathophysiology)

left-sided heart failure (type of ventricular heart failure)

Dyspnea from fluid in alveoli (associated pathophysiology)

left-sided heart failure (type of ventricular heart failure)

Orthopnea (associated pathophysiology)

left-sided heart failure (type of ventricular heart failure)

Pulmonary congestion predominates (associated pathophysiology)

left-sided heart failure (type of ventricular heart failure)

pericardiocentesis

procedure that involves aspiration of fluid from the pericardial sac

The most common thromboembolitic problem among patients with heart failure is:

pulmonary embolism

Ascites (associated pathophysiology)