Medical Surgical Heart failure #3

Question

The nurse is caring for a hospitalized client with admitting diagnosis of right-sided heart failure (HF). What assessment finding is most consistent with the client’s diagnosis?

Answers

  1. Pulmonary edema
    • Rationale:

      This answer is not correct because left-sided heart failure (not right-sided) is most associated with pulmonary symptoms which include pulmonary edema, dry, hacking cough, pulmonary edema, dry, hacking cough, paroxysmal nocturnal dyspnea, and exertional dyspnea, and orthopnea, and orthopnea. Left HF produces “lung” or pulmonary symptoms whereas right-sided heart failure generally produces systemic symptoms, such as weight gain, distended neck veins or jugular vein distention (JVD), and swelling of the liver.

  2. Distended neck veins
    • Rationale:

      This answer is correct because right-sided heart failure (HF) occurs as a result of inefficient pumping of the right side of the heart, causing fluid buildup in the abdomen, face/neck, legs, and feet. Fluid backs up into the body because the right side of the heart is not pumping efficiently. Excessive fluid causes weight gain, distended neck veins or jugular vein distention (JVD), and swelling of the liver.

  3. Dry hacking cough
    • Rationale:

      This answer is not correct because left-sided heart failure (not right-sided) is most associated with pulmonary symptoms which include pulmonary edema, dry, hacking cough, pulmonary edema, dry, hacking cough, paroxysmal nocturnal dyspnea, and exertional dyspnea, and orthopnea, and orthopnea. Left HF produces “lung” or pulmonary symptoms whereas right-sided heart failure generally produces systemic symptoms, such as weight gain, distended neck veins or jugular vein distention (JVD), and swelling of the liver.

  4. Orthopnea
    • Rationale:

      This answer is not correct because left-sided heart failure (not right-sided) is most associated with pulmonary symptoms which include pulmonary edema, dry, hacking cough, pulmonary edema, dry, hacking cough, paroxysmal nocturnal dyspnea, and exertional dyspnea, and orthopnea, and orthopnea. Left HF produces “lung” or pulmonary symptoms whereas right-sided heart failure generally produces systemic symptoms, such as weight gain, distended neck veins or jugular vein distention (JVD), and swelling of the liver.

Overview

Right-sided heart failure (HF) occurs as a result of inefficient pumping of the right side of the heart, causing fluid buildup in the abdomen, face/neck, legs, and feet, causing weight gain, distended neck veins or jugular vein distention (JVD), and swelling of the liver.

Explanation

Learning Outcomes

Right-sided heart failure (HF) occurs as a result of inefficient pumping of the right side of the heart, causing fluid buildup in the abdomen, face/neck, legs, and feet. Fluid backs up into the body because the right side of the heart is not pumping efficiently. Excessive fluid causes weight gain, distended neck veins or jugular vein distention (JVD), and swelling of the liver. Left-sided heart failure is most associated with pulmonary symptoms which include pulmonary edema, dry, hacking cough, paroxysmal nocturnal dyspnea, and exertional dyspnea, and orthopnea. Heart rate may be irregular and a common arrhythmia with HF is atrial fibrillation.

Test Taking Tip

Remember: “Right-sided heart failure- Right back to the body”. In right sided heart failure, the right ventricle can not contract well enough to push blood to the lungs so the blood goes “Right back to the body”, causing symptoms of edema and extra fluid collection in various parts of the body, including periorbital edema, weight gain, distended neck veins or jugular vein distention (JVD), and swelling of the liver.

Video Rationale