Exam (elaborations)
NUR 212 EAQ- Heart Failure
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NUR 212 EAQ- Heart FailureWhich respiratory rate would the nurse anticipate when assessing a patient who is developing
pulmonary edema? - ANS 32 to 36 breaths/min.
A respiratory rate higher than 30 breaths/min is often found in patients with pulmonary edema. A
patient experiences dyspnea and orthopnea as a result of the accumulation of edematous fluid in
the lung tissues, which affects the patient's respiratory rate. Respiratory rates in the ranges of 10 to
24 breaths/min indicate normal respiration. p. 739
Which term is used to describe difficulty breathing when lying down? - ANS Orthopnea.
Which information would the nurse include in the dietary education for a patient with heart failure
(HF)? - ANS Guidelines for a low-sodium diet.
A patient is diagnosed with paroxysmal nocturnal dyspnea. Which clinical manifestation would the
nurse expect the patient to report? - ANS Awakening with a feeling of suffocation.
Paroxysmal nocturnal dyspnea occurs when the patient is asleep. The patient awakes in a state of
panic with a feeling of suffocation and has a strong desire to sit or stand up. Breathlessness on
exertion is called dyspnea. Shortness of breath when lying down, that is, orthopnea, often
accompanies dyspnea. A decreased attention span is a behavioral change that may be a result of
poor gas exchange or worsening heart failure. p. 740
A patient with a recent diagnosis of heart failure (HF) has been prescribed furosemide. Which
physiologic effect would the nurse expect this medication to have? - ANS Reduce preload.
Which assessment finding is consistent with right-sided heart failure (HF)?
Jugular venous distention (JVD)
2
Presence of S3 and S4 heart sounds
3
Paroxysmal nocturnal dyspnea (PND)
4
, Displacement of the point of maximal impulse (PMI) - ANS Jugular venous distention (JVD.)
JVD is a sign of right-sided HF. Presence of S3 and S4 heart sounds, PND, and displacement of the
PMI are all signs/symptoms of left-sided HF. p. 740
Which effect would be expected from a medication that acts to increase chronotropy? - ANS
Increased heart rate.
Increased heart rate is a positive chronotropic effect. Increases in myocardial contractility, stroke
volume, and cardiac output are positive inotropic effects. p. 737
Which area of the body would best show accumulation of edema in a patient with heart failure (HF)
who spends most of the time in bed?
Feet
Lungs
Sacrum
Abdomen - ANS Sacrum.
In patients with HF who spend a great deal of time in bed, it would be important to assess the sacral
area for edema. Edema related to HF may also be found in the feet, lungs, and abdomen. But in this
patient, given the history of bed rest, the sacrum will be the most accurate area to assess. p. 740
Which type of drug therapy is used to treat volume overload in patients with acute decompensated
heart failure (ADHF)? - ANS Diuretics.
An acutely ill patient develops unexplained, new-onset heart failure (HF) that is unresponsive to
usual care. Which diagnostic procedure is likely to take place during heart catheterization? - ANS
Endomyocardial biopsy (EMB.)
Which condition increases a patient's risk for digoxin toxicity? - ANS Hypokalemia.
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