Medical Surgical Heart failure #2

Question

The nurse is assessing an elderly client admitted with a diagnosis of chronic heart failure (HF). The spouse asks the nurse the primary cause for HF, and the nurse responds that HF may be caused by:

Answers

  1. Endocarditis
    • Rationale:

      This answer is not correct because endocarditis is caused by an infection of the endocardium (usually bacteria, fungi, and from migration of bacteria from other parts of the body). While endocarditis may have complications if left untreated, it does not fit the diagnosis for chronic HF.

  2. Pleural effusion
    • Rationale:

      This answer is not correct because pleural effusion is a collection of fluid in the pleural space, and may arise from cardiopulmonary disorders or systemic inflammatory disorders (such as cancer); however, is not the primary cause for chronic HF.

  3. Atherosclerosis
    • Rationale:

      This answer is correct because atherosclerosis is the buildup of cholesterol and other substances that adhere to the cell wall may narrow arteries and affect arterial dilation and expansion and ability to carry blood supply resulting in coronary artery disease (CAD). Atherosclerosis in the arteries that causes plaque within the arteries that can eventually occlude the artery that can reduce or eliminate blood flow to the heart. This blockage of blood flow to the heart can produce myocardial infarction that leads to death of myocardial tissue. Then that part of the heart does not function properly so the decreased ability to contract and move myocardial blood through the heart properly then leads to heart failure. Heart failure then produces further decreased cardiac output, leading to build up of fluid and chronic heart failure.

  4. Atrial-septal defect
    • Rationale:

      This answer is not correct because although atrial septal defects may result in HF, manifestation may occur from infancy through early childhood, and adults with undetected atrial septal defects may also have pulmonary hypertension, shortened life span, and may have HF. The selection of atrial septal defect does not fit the question since the client is elderly, with chronic HF, and better fits the selection for atherosclerosis.

Overview

Atherosclerosis is the buildup of plaque that can lead to occlusion of arteries, myocardial infarction, and chronic heart failure.

Explanation

Learning Outcomes

Atherosclerosis is the buildup of cholesterol and other substances that adhere to the cell wall may narrow arteries and affect arterial dilation and expansion and ability to carry blood supply resulting in coronary artery disease (CAD). Atherosclerosis in the arteries that causes plaque within the arteries that can eventually occlude the artery that can reduce or eliminate blood flow to the heart. This blockage of blood flow to the heart can produce myocardial infarction that leads to death of myocardial tissue. Then that part of the heart does not function properly so the decreased ability to contract and move myocardial blood through the heart properly then leads to heart failure. Heart failure then produces further decreased cardiac output, leading to build up of fluid and chronic heart failure.

Test Taking Tip

Remembering the pathophysiologic connection between conditions in the body can help lead you to correct answers, such as atherosclerosis can lead to myocardial infarction, which can lead to and heart failure.

Video Rationale