PATHO test three
Left-sided heart failure signs & symptoms
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Right-sided heart failure signs & symptoms
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In hypovolemic shock, renal perfusion and urinary output decline. The nurse will monitor urinary output and knows that output below which of the following levels indicates inadequate renal perfusion?
20 mL/hour In hypovolemia, renal vasculature is constricted in a compensatory attempt to circulate blood to more vital organs. Urinary output at 20 mL/hour or below indicates that renal perfusion is too inadequate.
hypovolemic shock
A condition in which the liquid portion of the blood (plasma) is too low. Causes of hypovolemia include vomiting, diarrhea, and excessive bleeding. Symptoms include weakness, fatigue, fainting, and dizziness. Hypovolemic shock also can result from an internal hemorrhage or from third-space losses, when extracellular fluid is shifted from the vascular compartment to the interstitial space or compartment, without fluid movement in/out of the cells.
A nurse is assessing a client in shock for complications of acute renal failure. The most important assessment for the nurse to obtain would be:
Continuous measurement of urine output Continuous monitoring of urine output during shock provides a means of assessing renal blood flow.
The nurse knows that persons with atrial fibrillation are at risk of developing which cardiac complication?
Diastolic dysfunction In atrial fibrillation, the lack of coordinated atrial contraction will decrease ventricular filling and thus decrease the volume of blood available for cardiac output.
In the ICU setting, clients who develop shock need thorough head-to-toe assessments. Which of the following clinical manifestations would alert the health care provider that the client may be developing ischemia associated with gastrointestinal redistribution of blood flow?
Gastric bleeding Bleeding is a common symptom of gastrointestinal ulceration caused by shock, with onset usually within 2 to 10 days after the original insult.
An 86-year-old male client is disappointed to learn that he has class II heart failure despite a lifelong commitment to exercise and healthy eating. Which of the following age-related changes predisposes older adults to developing heart failure?
Increased vascular stiffness Increased vascular stiffness in older adults causes a progressive increase in systolic blood pressure with advancing age, which in turn contributes to the development of left ventricular hypertrophy and altered diastolic filling.
A client who developed a deep vein thrombosis during a prolonged period of bed rest has deteriorated as the clot has dislodged and resulted in a pulmonary embolism. Which of the following types of shock is this client at risk of experiencing?
Obstructive shock Obstructive shock results from mechanical obstruction of the flow of blood through the central circulation, such as the blockage that characterizes a pulmonary embolism.
On a holiday trip home, the nurse's mother states that the nurse's father was diagnosed with right heart failure. Which of the following manifestations exhibited by the father does the nurse know might have preceded this diagnosis?
Peripheral edema weight gain In right failure. blood backs up into the venous side of the circulatory system causing increased hydrostatic pressure in capillaries and leakage of plasma which forms peripheral edema and becomes apparent as weight gain.
Assessment of an elderly female client reveals the presence of bilateral pitting edema of the client's feet and ankles and pedal pulses that are difficult to palpate. Auscultation of the client's lungs reveals clear air entry to bases, and the client's oxygen saturation level is 93%, and vital signs are within reference ranges. What is this client's most likely health problem?
Right-sided heart failure A major effect of right-sided heart failure is the development of peripheral edema.
What is the primary cause of heart failure in infants and children?
Structural (congenital) heart defects are the most common cause of heart failure in children
The health care provider is reviewing lab results of a client diagnosed with heart failure. The provider notes that the client's ANP and BNP levels have been increasing and remain significantly elevated. These results would be interpreted as:
The condition is getting progressively worse.
A nurse preceptor is evaluating the skills of a new registered nurse (RN) caring for clients experiencing shock. Why does raising the head of the bed to a high Fowler's position indicate a need for more education?
The person should be placed in a supine position. This is extremely important because venous return can be severely compromised in the sitting position. This in turn produces a pulseless mechanical contraction of the heart and predisposes to arrhythmias. In several cases, death has occurred immediately after assuming the sitting position.
A patient is told that she has cardiac valve leaflets, or cusps, that are floppy and fail to shut completely, permitting blood flow even when the valve should be completely closed. The nurse knows that this condition can lead to heart failure and is referred to as which of the following?
Valvular regurgitation
Systolic vs. Diastolic Heart Failure
With left-sided heart failure, you may have systolic or diastolic failure. Systolic failure happens when the heart doesn't pump out blood the way it should. Diastolic means the heart doesn't fill back up with blood as it should.
cardiogenic shock
a condition in which your heart suddenly can't pump enough blood to meet your body's needs most often caused by a severe heart attack
An elderly client has been diagnosed with chronic heart failure. He is prescribed an ACE inhibitor to treat the symptoms and improve his quality of life. This drug will alleviate the client's symptoms of heart failure by:
blocking the conversion of angiotensin I to angiotensin II.