Prep U Chapter 28 Med/Surg Heart Failure

A patient has been newly diagnosed with heart failure (HF) and has come to the meet with the nurse at the clinic for health education. What lifestyle recommendation should the nurse provide to this patient when discussing dietary modifications?

"It's in your best interests to avoid excessive fluids and sodium in your diet."

A client has had an echocardiogram to measure ejection fracton. The nurse explains that ejection fraction is the percentage of blood the left ventricle ejects upon contraction. What is the typical percentage of blood a healthy heart ejects?

55%

A patient is admitted to the hospital and is being evaluated for heart failure. Which diagnostic study is usually performed to confirm the diagnosis of heart failure?

Echocardiogram

The nurse is discussing cardiac hemodynamics with a nursing student. The nurse explains preload to the student and then asks the student what nursing interventions might cause decreased preload. The student correctly answers which of the following?

Administration of a vasodilating drug (as ordered by a physician)

A total artificial heart (TAH) is an electrically powered pump that circulates blood into the pulmonary artery and the aorta, thus replacing the functions of both the right and left ventricles. What makes it different from an LVAD?

An LVAD only supports a failing left ventricle.

What is the primary underlying disorder of pulmonary edema?

Decreased left ventricular pumping

Which diagnostic study is usually performed to confirm the diagnosis of heart failure?

Echocardiogram

EKG vs. Echocardiogram: The Relationship Between the Two?

In most cases, your physician will want you to undergo an EKG first to determine if there is any irregularity in heart rhythm that could be a sign of heart disease. Depending on the results, they may then order an echocardiogram to provide a more in-depth look at heart function. Used together, the two tests can greatly increase the accuracy of the diagnosis of many common heart conditions.

The nurse recognizes that an older adult patient with heart failure is experiencing the effects of inadequate cardiac output, a problem that affects many of the body's systems. Inadequate perfusion of the patient's kidneys leads to which of the following pathophysiological effects?

Increased renin release

A nurse is assessing a client with congestive heart failure for jugular vein distention (JVD). Which observation is important to report to the physician?

JVD is noted 4 cm above the sternal angle.

A patient has developed pulmonary edema during an exacerbation of heart failure. The patient is experiencing dyspnea primarily because of the accumulation of pressure in the patient's:

Left atrium

Which of the following medications is a human brain natriuretic peptide (BNP) preparation?

Natrecor

Which term describes the degree of stretch of the ventricular cardiac muscle fibers at the end of diastole?

Preload

A client is admitted to the hospital with systolic left-sided heart failure. The nurse knows to look for which of the following assessment findings for this client?

Pulmonary congestion

A patient is admitted to the intensive care unit (ICU) with left-sided heart failure. What clinical manifestations does the nurse anticipate finding when performing an assessment? (Select all that apply.)

Pulmonary crackles Dyspnea Cough

A client with heart failure reports a sudden change in the ability to perceive colors. The client reports nausea, and assessment reveals an irregular pulse of 39 beats per minute. What is the nurse's best action?

Report the possibility of digitalis toxicity to the care provider promptly

A nurse is administering nitroglycerin, which decreases afterload and preload. Afterload refers to which of the following?

The amount of resistance to the ejection of blood from the ventricles

A nurse is administering lanoxin, which she knows increases contractility as well as cardiac output. Contractility refers to which of the following?

The force of the contraction related to the status of the myocardium

A client with left-sided heart failure complains of increasing shortness of breath and is agitated and coughing up pink-tinged, foamy sputum. The nurse should recognize these findings as signs and symptoms of:

acute pulmonary edema.

A client has been diagnosed with congestive heart failure. This client's cardiac function has been compromised since the client suffered a myocardial infarction 3 years ago. Heart failure is classified by:

amount of activity restriction the failure imposes.

Left-sided heart failure results in several symptoms due to reduced cardiac output. Which symptom would NOT contribute to a diagnosis of heart failure?

polydipsia

A client was admitted to the cardiac ICU with full-blown pulmonary edema. After treatment, the nurse discusses the client's symptoms with the client. A typical, subtle symptom that communicates right-sided heart failure is gradual, unexplained:

weight gain