What did you learn?? Heart Failure

The nurse should assess the client with left sided HF for which findings? Select all that apply1. dyspnea2. JVD3. crackles4. RUQ pain5. oliguria6. decreased O2 sat

(Dyspnea, crackles, oliguria and decreased O2 sat are S/S related to pulmonary congestion and inadequate tissue perfusion associated with left-sided HF. JVD and RUQ pain along with ascites and edema are usually associated with congestion of the peripheral tissues and viscera in right-sided HF)

A client with chronic heart failure is able to continue with his regular physical activity and does not have any limitations as to what he can do. According to the New York Heart Association (NYHA), what classification of chronic heart failure does this client have? Class II (Mild) Class I (Mild) Class IV (Severe) Class III (Moderate)

Class I is when ordinary physical activity does not cause undue fatigue, palpitations, or dyspnea. The client does not experience any limitation of activity. Class II (Mild) is when the client is comfortable at rest, but ordinary physical activity results in fatigue, heart palpitations, or dyspnea. Class III (Moderate) is when there is marked limitation of physical activity. The client is comfortable at rest, but less than ordinary activity causes fatigue, heart palpitations, or dyspnea. Class IV (Severe), the client is unable to carry out any physical activity without discomfort. Symptoms of cardiac insufficiency occur at rest. Discomfort is increased if any physical activity is undertaken.

A client with right-sided heart failure is admitted to the medical-surgical unit. What information obtained from the client may indicate the presence of edema? The client says his rings have become tight and are difficult to remove. The client says he is short of breath when ambulating. The client says he has been hungry in the evening. The client says that he has been urinating less frequently at night.

Clients may observe that rings, shoes, or clothing have become tight. The client would most likely be urinating more frequently in the evening. Accumulation of blood in abdominal organs may cause anorexia, nausea, flatulence, and a decrease in hunger. Shortness of breath with ambulation would occur most often in left-sided heart failure.

A client has been diagnosed with congestive heart failure. Which is a cause of crackles heard in the bases of the lungs? Pulmonary hypertension Pulmonary congestion Mitral valve stenosis Aortic valve stenosis

Crackles heard in the bases of the lungs are a sign of PULMONARY CONGESTION. Heart palpitations are caused by tachydysrhythmias. Crackles heard in the bases of the lungs are not signs of pulmonary hypertension and mitral valve stenosis.

The nurse identifies which symptom as a characteristic of right-sided heart failure? Dyspnea Cough Jugular vein distention (JVD) Pulmonary crackles

JVD is a characteristic of right-sided heart failure. Dyspnea, pulmonary crackles, and cough are manifestations of left-sided heart failure.

A nurse is caring for a client with left-sided heart failure. What should the nurse anticipate using to reduce fluid volume excess? diuretics. oxygen. antiembolism stockings. anticoagulants.

diuretic Diuretics, such as furosemide, reduce total blood volume and circulatory congestion. Antiembolism stockings prevent venostasis and thromboembolism formation. Oxygen administration increases oxygen delivery to the myocardium and other vital organs. Anticoagulants prevent clot formation but don't decrease fluid volume excess.

A client is diagnosed with left-sided heart failure. Which treatment should the nurse anticipate being prescribed to reduce this client's excess fluid? anticoagulants diuretics oxygen anti-embolism stockings

diuretics

The nurse is teaching a client with heart failure about the ability for the heart to pump out blood. What diagnostic test will measure the ejection fraction of the heart? pulmonary arterial pressure MRI echocardiogram nuclear angiography

echocardiogram

An older adult with a history of HF is admitted to the ER with pulmonary edema. On admission, what should the nurse assess first?1. BP2. skin breakdown3. serum K level4. urine output

(It is a priority to assess the BP first because people with pulmonary edema typically experience severe HTN that requires early intervention. The client probably does not have skin breakdown, but when the client is stable and when the nurse obtains a complete health history, the nurse should inspect the clients skin for any signs of breakdown; however when the client is stable, the nurse should inspect the skin. K levels are not the first priority. The nurse should monitor urine output after the client is stable)

The nurse is caring for an older client with mild dementia admitted with HF. What nursing care will be helpful for this client in reducing potential confusion related to hospitalization and change in routine? select all that apply1. reorient freq to time, place and situation2. Put the client in a quiet room furthest from the nursing station3. Perform necessary procedures quickly4. Arrange for familiar pictures or special items at bedside5. Limit the clients visitors6. Spend time with the client, establishing a trusting relationship

(It is not unusual for the elderly client to become somewhat confused when "relocated" to the hospital, and this may be more difficult for those with known dementia. Frequent reorientation delivered patiently and calmly along with placing familiar items nearby so the client can see them may help reduce confusion related to hospitalization. Establishing a trusting relationship is important with every client but moreso with this client. Putting the client in a room further from the nursing station may decrease extra noise for the client but will also make it more difficult to observe this client and maintain a safe environment. Procedures should be explained to the client prior to proceeding and should not be rushed. Visits by the family and friends may help keep the client oriented.)

Which are indications that a client with a history of left-sided HF is developing pulmonary edema? Select all that apply1. distended jugular veins2. dependent edema3. anorexia4. course crackles5. tachycardia

(Signs of pulmonary edema are identical to those of acute HF. S/S are generally apparent in the respiratory system and include coarse crackle, severe dyspnea, and tachycardia. Severe tachycardia occurs due to sympathetic stimulation in the presence of hypoxemia. BP may be decreased OR elevated, depending on the severity of the edema. JVD, dependent edema, and anorexia are symptoms of RIGHT sided HF.

Captopril, furosemide, and metoprolol are prescribed for a client with systolic hear failure. The clients BP is 136/82 and the HR is 65 bpm. Prior to medication administration at 0900, the nurse reviews the following lab tests: NA 140 K 6.8 BUN 18 Creat 1.0 Hgb 12 Hct 37% What should the nurse do first? 1. Administer the medications 2. Call the HCP 3. Withhold the captopril 4. Question the metoprolol dose

(The nurse should withhold the dose of captopril; captopril is an ACE inhibitor, and a side effect of the medication is hyperkalemia. The BUN and creatinine which are normal, should be viewed prior to administration since renal insufficiency is another potential side effect of an ACE-1. The HR is within normal limits. The nurse should question the dose of metoprolol if the clients HR is bradycardic. The hbg and hct are normal for a female. The nurse should report the high K level and that the captopril was withheld.)

A client with chronic heart failure has atrial fibrillation and a left ventricular ejection fraction of 15 %. The client is taking warfarin. The expected outcome of this drug is to:1. decrease circulatory overload2 improve the myocardial workload3. prevent thrombus formation4. regulate cardiac rhythm

(Warfarin is an anticoagulant which is used in the treatment of atrial fibrillation and decrease ventricular ejection fraction (<20%) to preven thrombus formation and release of emboli into the circulation. The client may also take other medications as needed to manage heart failure. Warfarin does not reduce circulatory load or improve myocardial workload. Warfarin does not affect cardiac rhythm.)

A client has a history of HF and has been prescribed furosemide, digoxin, and potassium chloride. The client has nausea, blurred vision, headache, and weakness. The nurse notes that the client is confused. The telemetry strip shows first degree atrioventricular block. The nurse should assess the client for signs of :1. hyperkalemia2. digoxin toxicity3. fluid deficit4. pulmonary edema

(early signs of digoxin toxicity include anorexia, N/V. Visual disturbances can also occur, including double or blurred vision and visual halos. Hypokalemia is a common cause of digoxin toxicity associated with arrhythmias because low serum K can enhance ectopic pacemaker activity. Although vomiting can lead to fluid deficit, given the clients history, the vomiting is likely due to the adverse effects of digoxin toxicity. Pulmonary edema is manifested by dyspnea and coughing)

A client with stage IV heart failure has a living will indicating a ventilator may not be used. The client begins experiencing severe dyspnea. What should the nurse who is caring for this client do? ask the client's family to consent to ventilator placement. call for respiratory therapy to intubate the client. administer oxygen and hope the client will reconsider. administer oxygen, morphine, and a bronchodilator for client comfort.

Administer oxygen, morphine, and a bronchodilator for client comfort. A living will is a statement of a client's wishes in the event that a life-threatening illness or injury occurs. The client's comfort should be paramount and the nurse should respect the client's wishes. Morphine, oxygen, and bronchodilators can relieve dyspnea and make the client more comfortable, which will enable the client to breathe more easily. The nurse shouldn't arrange for intubation without the client's consent or ask family members for permission to initiate mechanical ventilation.

A female client presents to the emergency department with nausea, vomiting, and a heart rate of 45 beats per minute. Her husband states that she takes digoxin, Lasix, and nitroglycerin for chest pain. Laboratory results confirm digoxin toxicity. The nurse would expect the health care provider to order what medication to treat the bradycardia? Atropine Nifedipine Nitroglycerin Nesiritide

Atropine or isoproterenol, used in the management of bradycardia or conduction defects, may be administered to clients with digoxin toxicity.

Which is a key diagnostic indicator of heart failure? Creatinine Complete blood count (CBC) Brain natriuretic peptide (BNP) Blood urea nitrogen (BUN)

BNP is the key diagnostic indicator of HF. High levels of BNP are a sign of high cardiac filling pressure and can aid in the diagnosis of heart failure. BUN, creatinine, and a CBC are included in the initial workup.

A client diagnosed with heart failure presents with a temperature of 99.1° F, pulse 100 beats/minute, respirations 42 breaths/minute, BP 110/50 mm Hg; crackles in both lung bases; nausea; and pulse oximeter reading of 89%. Which finding indicates a need for immediate attention? nausea blood pressure temperature lung congestion

Because pulmonary edema can be fatal, LUNG CONGESTION needs to be relieved as quickly as possible. Supplemental oxygen or mechanical ventilation is used to support breathing. Inotropic medications, which improve myocardial contractility, are administered to relieve symptoms.

A client with heart failure is having a decrease in cardiac output. What indication does the nurse have that this is occurring? Heart rate of 72 beats/minute Respiratory rate of 20 breaths/minute Oxygen saturation 94% Blood pressure 80/46 mm Hg

Blood pressure 80/46 mm Hg The body can compensate for changes in heart function that occur over time. When cardiac output falls, the body uses certain compensatory mechanisms designed to increase stroke volume and maintain blood pressure. These compensatory mechanisms can temporarily improve the client's cardiac output but ultimately fail when contractility is further compromised. A heart rate of 72 beats/minute is within normal range as well as the blood pressure and oxygen saturation.

A patient is seen in the emergency department (ED) 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? Complete blood count (CBC) B-type natriuretic peptide (BNP) Serum electrolytes Blood urea nitrogen (BUN)

The BNP level is a key diagnostic indicator of HF; high levels are a sign of high cardiac filling pressure and can aid in both the diagnosis and management of HF (Institute for Clinical Systems Improvement [ICSI], 2011).

A patient has been diagnosed with congestive heart failure (CHF). The health care provider has ordered a medication to enhance contractility. The nurse would expect which medication to be prescribed for the patient? Enoxaparin Digoxin Clopidogrel Heparin

Contractility is enhanced by circulating catecholamines, sympathetic neuronal activity, and certain medications, such as DIGOXIN/Lanoxin. Increased contractility results in increased stroke volume. The other medications are classified as platelet-inhibiting medications.

The nurse is providing discharge teaching to a patient diagnosed with heart failure. What should the nurse teach this patient to do to monitor fluid balance? Assess radial pulses. Monitor blood pressure. Monitor weight daily. Monitor bowel movements

Daily weights at the same time every day can be a good indicator of fluid balance. Assessing radial pulses and monitoring the blood pressure may be done, but they do not provide information about fluid balance.

A client is being treated for heart failure. What assessment finding would the nurse interpret as most indicative of improved health status? Decreased pitting edema Increased skin turgor Improved sensorium Heart rate of 52

Decreased pitting edema The absence of pitting edema, decreased size of ankles and abdominal girth, and decreased weight improves circulation and increases renal blood flow. The diminished fluid volume is indicative of an improved blood supply to the body tissues. Increased skin turgor indicates that the client is well hydrated and does not have fluid volume excess. A heart rate of 52 is too slow to provide good contractility. Improved sensorium indicates adequate perfusion but is not the most indicative of improved heart failure status.

The nurse is taking a health history of a 6-week-old boy with a suspected cardiovascular disorder. Which response by the mother would lead the nurse to suspect that the child is experiencing heart failure? "He does not seem short of breath." "He seems to have a normal appetite." "He gets sweaty when he eats." "He does not seem sick."

Diaphoresis with nipple feeding indicates heart failure. Shortness of breath would suggest heart failure. Children with heart failure experience subtle signs that suggest that something is wrong. Children with heart failure often display subtle signs such as difficulty feeding.

The nurse is preparing to administer digoxin to a client with heart failure. The nurse obtains an apical pulse rate for 1 minute and determines a rate of 52 beats/minute. What is the first action by the nurse? Administer the medications and then notify the physician. Administer atropine to speed the heart rate and then administer the digoxin. Withhold the medication and notify the physician of the heart rate. Administer the medication and inform the charge nurse about the rate.

Digitalis drugs are withheld if the heart rate is less than 60 or more than 120 beats/minute until a physician is consulted. The other choices would have the nurse administer the drug, which would not be the standard of practice.

A client is prescribed digitalis medication. Which condition should the nurse closely monitor when caring for the client? Vasculitis Vasculitis nausea and vomiting Flexion contractures Enlargement of joints

Digitalis medications are potent and may cause various toxic effects. The nurse should monitor the client for signs of digitalis toxicity, not just during the initial period of therapy, but throughout care management. The most common signs and symptoms include NAUSEA & VOMITING which can lead to dehydration and electrolyte imbalance. Symptoms of toxicity do not include vasculitis, flexion contractures, or enlargement of joints.

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? visual disturbances. nocturia and sleep disturbances. dry mouth and urine retention. taste and smell alterations.

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). D: Double Vision/diplopia/Depression I: Irritability & Irregular ECG's G: GI symptoms ( N&V, dehydration) O: Overly tired (lethargy & fatigue) I: Intolerance to light (photo-phobia) N: Nervous System S&S ( HA, memory loss, seizures, hallucinations, delusions)

The diagnosis of heart failure is usually confirmed by which of the following? Electrocardiogram (12-lead) Echocardiogram Chest x-ray Ventriculogram

Echocardiogram

The nurse is teaching an elderly client about heart failure. What action will the nurse do to enhance learning? frequently repeat the provided information sit in a chair a few feet away from the client look at notes to ensure all information is covered provide the necessary information in one teaching session

Effective teaching strategies for older adults include frequent repetition of information. Giving small amounts of information in multiple sessions is more effective for learning than providing a lot of information in one teaching session. The nurse needs to look at the client rather than notes to assist the client with speech reading. The nurse should sit near the client so the client can hear the nurse.

The nurse's morning assessment of a client who has a history of heart failure reveals the presence of 2+ pitting edema in the client's ankles and feet bilaterally. Which action should the nurse take to help alleviate the edema? Deeply massage the legs Direct the client to remain on bed rest Request additional salt be added to the diet Elevate the legs

Elevate the legs Edema is a characteristic sign of fluid volume excess (hypervolemia). To reduce edema, the nurse should encourage movement, elevate the legs, stroke the legs using light pressure to encourage movement of fluid back toward the heart, and apply compression stockings to encourage movement of fluid back toward the heart. In addition, the reduction of salt in the diet may decrease edema.

The nurse is caring for a client with left-sided heart failure causing chronic activation of the renin-angiotensin-aldosterone system (RAAS). What is the nurse's priority assessment? Decreased blood pressure when standing Fluid volume excess Increased urine output Hyperkalemia

Fluid volume excess Activation of the RAAS results in an increase in vascular tone (elevation of BP) and renal RETENTION OF SODIUM AND WATER, which will reduce urine output and contribute to the LOSS of potassium.

The nurse is reviewing the results of the patient's echocardiogram and observes that the ejection fraction is 35%. The nurse anticipates that the patient will receive treatment for what condition? Myocardial infarction Pulmonary embolism Pericarditis Heart failure

Heart Failure An ejection fraction of less than 40% indicates that the patient has decreased left ventricular function and likely requires treatment for heart failure.

A nurse is caring for a client experiencing dyspnea, dependent edema, hepatomegaly, crackles, and jugular vein distention. What condition should the nurse suspect? Pulmonary embolism Heart failure Tension pneumothorax Cardiac tamponade

Heart failure A client with heart failure has decreased cardiac output caused by the heart's decreased pumping ability. A buildup of fluid occurs, causing dyspnea, dependent edema, hepatomegaly, crackles, and jugular vein distention. A client with pulmonary embolism experiences acute shortness of breath, pleuritic chest pain, hemoptysis, and fever. A client with cardiac tamponade experiences muffled heart sounds, hypotension, and elevated central venous pressure. A client with tension pneumothorax has a deviated trachea and absent breath sounds on the affected side as well as dyspnea and jugular vein distention.

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. It is specifically designed for long-term use. It never needs batteries. It is designed for extremely active patients.

Left Ventricular assist device A TAH is considered an extension of LVADs, which only support a failing left ventricle. TAHs are targeted for clients who are unlikely to live more than a month without further interventions.

Medical management of cardiac failure uses similar methodology whether it is right-sided or left-sided. Measures such as dietary modification, lifestyle changes, medications to reduce dyspnea and relieve anxiety, etc. are all used with one primary intention. The primary goal in the medical management of heart failure is to reduce cardiac workload. oxygenation. cardiac output. pulmonary efficacy.

Medical management of both left-sided and right-sided heart failure is directed at REDUCING THE HEARTS WORKLOAD and improving cardiac output. There is no reason for reducing pulmonary efficacy. There is no reason for reducing oxygenation.

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? Low-sodium diet Low-cholesterol diet Low-potassium diet Low-fat diet

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 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.

A nursing student observes the home care nurse provide education to a client with congestive heart failure (CHF). The nurse teaches the client how to read food labels and calculate sodium content. The nursing student recognizes that the home care nurse is aware of which basic principle of patient education? Patient instruction related to self-care activities promotes patient independence The home care nurse is providing hospital discharge instructions The home care nurse has a physician order to teach a 2-g sodium diet Patients are required to learn about their therapeutic nutritional regimen

Patient instruction related to self-care activities promotes patient independence Teaching is a function of nursing to assist patients to alter lifestyle patterns that increase health risk. By teaching the client how to calculate sodium content of foods the nurse is facilitating independence in nutrition disease management. Patients have the right to decide whether or not to learn. Teaching is an independent function of nursing and does not require a physician's order. Teaching related to food labels in the patient home is an appropriate environment for this client. The nurse can use actual foods from the patient's kitchen.

A client is receiving captopril for heart failure. During the nurse's assessment, what sign indicates that the medication therapy is ineffective? skin rash postural hypotension peripheral edema dry cough

Peripheral edema is a sign of fluid volume excess and worsening heart failure. A skin rash, dry cough, and postural hypotension are adverse reactions to captopril, but they don't indicate that therapy is ineffective.

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? Left-sided heart failure Chronic heart failure Acute heart failure Right-sided heart failure

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 has been diagnosed with heart failure. What is the major nursing outcome for the client? Sleep 8 hours per night. Walk 30 minutes three times a week. Maintain a healthy diet. Reduce the workload on the heart.

Specific objectives of medical management of heart failure include REDUCING THE WORKLOAD OF THE HEART by reducing preload and afterload. The other choices are objectives that may be supportive of a healthy lifestyle, but are not specific to a client with heart failure.

During an assessment of a client with ankle swelling, the nurse observes jugular venous pulsations 5 cm above the sternal angle when the head of his bed is elevated 45 degrees. What is the correct interpretation of this finding? The client has decreased fluid volume. The client has an increased cardiac output. The client has increased pressure related to right-sided heart failure. The client has stenosis of the jugular veins.

The client has increased pressure related to right-sided heart failure The jugular veins are normally flat or collapsed. Since there are no valves at the atrial sites (i.e., venae cavae and pulmonary veins) where blood enters the heart, they can become prominent in severe right-sided heart failure. This means that excess blood is pushed back into the veins when the atria become distended.

A nurse is teaching a client about heart failure. What will the nurse explain is causing the heart to fail? The heart cannot pump sufficient blood to meet the body's metabolic needs. The heart is fibrillating. The heart is pumping too fast to adequately meet the body's metabolic needs. The heart is pumping too slow to disseminate nutrients to the body.

The heart cannot pump sufficient blood to meet the body's metabolic needs. Heart failure is the INABILITY OF THE HEART TO PUMP SUFFICIENT BLOOD to meet the body's metabolic needs. Heart failure does not mean the heart pumps too fast or to slow; it means it cannot contract effectively to eject the blood in the ventricles. A fibrillating heart involves a problem with conduction, not failure.

The nurse is caring for a client with heart failure. What procedure should the nurse prepare the client for in order to determine the ejection fraction to measure the efficiency of the heart as a pump? A chest radiograph Electrocardiogram A pulmonary arteriography Echocardiogram

The heart's ejection fraction is measured using an ECHOCARDIOGRAM or multiple gated acquisition scan. A pulmonary arteriography is used to confirm cor pulmonale. A chest radiograph can reveal the enlargement of the heart. An electrocardiogram is used to determine the activity of the heart's conduction system.

The client's digoxin level is 0.125. How does the nurse interpret this level? Normal Elevated Toxic Low

The normal digoxin level is 0.5 to 2.0 ng/mL. Serum levels greater than 2 ng/mL are toxic; however, toxicity may occur at any serum level.

The nursing instructor is teaching their clinical group how to assess a client for congestive heart failure. How would the instructor teach the students to assess a client with congestive heart failure for nocturnal dyspnea? By questioning how many pillows the client normally uses for sleep By observing the client's diet during the day By measuring the client's abdominal girth By collecting the client's urine output

The nurse should ask the client about nocturnal dyspnea by questioning how many pillows the client normally uses for sleep. This is because being awakened by breathlessness may prompt the client to use several pillows in bed. Collecting the client's urine output, observing the client's diet, or measuring the client's abdominal girth does not help assess for nocturnal dyspnea.

Which is a potassium-sparing diuretic used in the treatment of heart failure (HF)? Spironolactone Bumetanide Ethacrynic acid Chlorothiazide

Think "Spire" and "Spare" sound alike Spironolactone is a potassium-sparing diuretic. Chlorothiazide is a thiazide diuretic is Diuril. Bumetanide and ethacrynic acid are loop diuretics.

The student nurse is caring for a client with heart failure. Diuretics have been ordered. What method might be used with a debilitated client to help the nurse evaluate the client's response to diuretics? Using a urinary catheter Using a biventricular pacemaker Using mechanical ventilation Using a pulmonary artery catheter

To evaluate response to diuretics, a urinary catheter is used. Mechanical ventilation helps maintain a normal breathing pattern. A pulmonary artery catheter helps estimate cardiac output. A biventricular pacemaker is used to sustain life.

The nurse is admitting an older adult client with heart failure. Which education will the nurse prepare for this client prior to discharge?" Continue to increase the amount of exercise, because cardiac output increases with age. Any kind of stress is acceptable, because the aging heart has an increased ability to respond. Exercise tolerance should remain the same as in younger years. Try to avoid emotional stress and take part in mild physical stress only.

Try to avoid emotional stress and take part in mild physical stress only. Stressful physical and emotional conditions may have adverse effects on the aged person's heart. Stress is not tolerated by older adults with heart failure. Exercise regimes need to be tailored to the older adult's ability. Cardiac output does not increase with age.

Which particular area(s) should be examined to assess peripheral edema? Upper arms Feet, ankles Under the sacrum Lips, earlobes

When right-sided heart failure occurs, blood accumulates in the vessels and backs up in peripheral veins, and the extra fluid enters the tissues. Particular areas for examination are the dependent parts of the body, such as the FEET & ANKLES. Other prominent areas prone to edema are the fingers, hands, and over the sacrum. Cyanosis can be detected by noting color changes in the lips and earlobes.

A hospitalized client with heart failure puts on the call light and states, "I've become very short of breath, and I've been coughing up this pink frothy sputum." The nurse immediately suspects which of the following complications?

When the left ventricle fails, blood backs up into the pulmonary system. Large quantities of frothy sputum, which is sometimes blood-tinged, may be produced, indicating severe pulmonary congestion or pulmonary edema.

A new client has been admitted with right-sided heart failure. When assessing this client, the nurse knows to look for which finding? Dyspnea Cough Pulmonary congestion Jugular venous distention

When the right ventricle cannot effectively pump blood from the ventricle into the pulmonary artery, the BLOOD BACKS UP INTO THE VENOUS SYSTEM AND CAUSES JUGULAR VENOUS DISTENTIONand congestion in the peripheral tissues and viscera. All the other choices are symptoms of left-sided heart failure.