Heart Failure

A patient has been experiencing increasing shortness of breath and fatigue. The physician has ordered a diagnostic test in order to determine what type of heart failure the patient is having. What diagnostic test does the nurse anticipate being ordered?

an echocardiogram

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?

arterial blood gases

Why does a client with left-sided heart failure require careful monitoring?

Right-sided heart failure is a risk.

A client with heart failure has met with his primary provider and begun treatment with an angiotensin-converting enzyme (ACE) inhibitor. When the client begins treatment, the nurse should prioritize what assessment?

blood pressure

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?

call for chest x-ray

A client who has developed congestive heart failure must learn to make dietary adaptations. The client should avoid:

canned peas

A client has a significant history of congestive heart failure. What should the nurse specifically assess during the client's semiannual cardiology examination? Select all that apply.

-Examine the client's neck for distended veins. -Monitor the client for signs of lethargy or confusion.

A nurse is caring for a client with heart failure. The nurse knows that the client has left-sided heart failure when the client makes which statement?

"I sleep on three pillows each night."

The nurse recognizes that which laboratory test is a key diagnostic indicator of heart failure?

BNP

The nurse is caring for an older adult client who has just returned from the OR after inguinal hernia repair. The OR report indicates that the client received large volumes of IV fluids during surgery and the nurse recognizes that the client is at risk for left-sided heart failure. What signs and symptoms would indicate left-sided heart failure?

Bibasilar fine crackles

Which New York Heart Association classification of heart failure (HF) has a poor prognosis and includes symptoms of cardiac insufficiency at rest?

IV

The nurse is conducting a morning assessment of an 80-year-old female patient who has a longstanding diagnosis of heart failure (HF). The nurse notes an elevation in jugular venous pressure (JVP) greater than 4 cm above the woman's sternal angle, a finding that did not exist the day before. What conclusion should the nurse draw from this assessment finding?

The woman may be experiencing an exacerbation of right-sided HF.

A client is at risk for excess fluid volume. Which nursing intervention ensures the most accurate monitoring of the client's fluid status?

Weighing the client daily at the same time each day

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?

Withhold the drug and inform the primary health care provider.

A patient is being discharged to home. The nurse must emphasize the importance of being weighed daily. Which significant weight change would need to be reported to the patient's health care provider?

a weight gain of 2.5 pounds in one day

A client with left-sided heart failure reports 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 what condition?

acute pulmonary edema

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

Frequently, what is the earliest symptom of left-sided heart failure?

dyspnea on exertion

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%

The nurse is reviewing a newly admitted client's electronic health record, which notes a history of orthopnea. What nursing action is most clearly indicated?

Avoid positioning the client supine.

Which is a key diagnostic indicator of heart failure?

Brain natriuretic peptide (BNP)

A patient has been admitted to the hospital with exacerbation of heart failure (HF) that has resulted in pulmonary and peripheral edema. The nurse has been carefully monitoring the trajectory of the patient's signs and symptoms of HF. How can the nurse best monitor the patient's fluid balance?

By performing daily weights at the same time each day

A client has been prescribed furosemide 80 mg twice daily. The asymptomatic client begins to have rare premature ventricular contractions followed by runs of bigeminy with stable signs. What action will the nurse perform next?

Check the client's potassium level.

The nurse is caring for a client with systolic heart failure whose previous adverse reactions rule out the safe use of ACE inhibitors. The nurse should anticipate that the prescriber may choose what combination of drugs?

Combination of hydralazine and isosorbide dinitrate

A client has been having cardiac symptoms for several months and is seeing a cardiologist for diagnostics to determine the cause. How will the client's ejection fraction be measured?

echocardiogram

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

echocardiogram

A nurse caring for a client recently admitted to the ICU observes the client coughing up large amounts of pink, frothy sputum. Lung auscultation reveals course crackles to lower lobes bilaterally. Based on this assessment, the nurse recognizes this client is developing

decompensated heart failure with pulmonary edema.

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

diuretics

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

dyspnea cough pulmonary crackles

A patient has been prescribed a digitalis preparation for heart failure. What should the nurse closely monitor when caring for this client?

electrolyte and water loss

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

jVD is noted 4 cm above the sternal angle.

A client has been rushed to the ED with pulmonary edema and is going to need oxygen immediately. Which oxygen delivery system should be used first?

mask

The nurse is providing discharge education to a client diagnosed with heart failure. What should the nurse teach this client to do to assess fluid balance in the home setting?

monitor weight daily

When the nurse observes that the patient has increased difficulty breathing when lying flat, the nurse records that the patient is demonstrating

orthopnea

Which describes difficulty breathing when a client is lying flat?

orthopnea

The patient with cardiac failure is taught to report which of the following symptoms to the physician or clinic immediately?

persistent cough

The nurse is caring for an adult client whom the nurse suspects has digoxin toxicity. In addition to physical assessment, the nurse should collect what assessment information?

potassium level

The nurse overseeing care in the ICU reviews the shift report on four clients. The nurse recognizes which client to be at greatest risk for the development of cardiogenic shock?

the client admitted following an MI

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.

A patient is prescribed digitalis preparations. Which of the following conditions should the nurse closely monitor when caring for the patient?

potassium levels

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?

pulmonary congestion