Medical Surgical Heart failure #4

Question

The nurse is assessing a client admitted to the telemetry unit from the Emergency Department with complaints of increasing shortness of breath, and is coughing pink-tinged frothy sputum. During the history assessment, the nurse documents a history of left-sided heart failure. The nurse recognizes the presenting signs and symptoms of which health problem?

Answers

  1. Right-sided heart failure
    • Rationale:

      This answer is not 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.

  2. Acute pulmonary edema
    • Rationale:

      Left-sided heart failure occurs as a result of inefficient pumping of the left side of the heart, causing fluid buildup in the pulmonary system. Therefore, left-sided HF is most associated with pulmonary symptoms which include pulmonary edema which results in coughing pink-tinged frothy sputum and increasing shortness of breath. Other left sided HF symptoms include dry, hacking cough, paroxysmal nocturnal dyspnea, exertional dyspnea, and orthopnea. Cardiogenic causes of pulmonary edema are due to poor heart function and result in congestive heart failure. Other causes (non-cardiogenic) are from acute respiratory distress syndrome, trauma, kidney failure, and other causes.

  3. Bacterial pneumonia
    • Rationale:

      This answer is not correct because coughing pink-tinged frothy sputum is not associated with bacterial pneumonia. A cough with phlegm that could be thick, yellowish (indicating infection)is most associated with bacterial pneumonia. Left-sided HF is most associated with pulmonary symptoms which include pulmonary edema which results in coughing pink-tinged frothy sputum and increasing shortness of breath.

  4. Myocardial infarction
    • Rationale:

      This answer is not correct because myocardial infarction (MI) has symptoms of pain (chest, arm, jaw), shortness of breath, and diaphoresis, but not coughing pink-tinged frothy sputum is associated with MI. Left-sided HF is most associated with pulmonary symptoms which include pulmonary edema which results in coughing pink-tinged frothy sputum and increasing shortness of breath.

Overview

Left-sided heart failure is most associated with pulmonary symptoms which include pulmonary edema which results in coughing pink-tinged frothy sputum and increasing shortness of breath.

Explanation

Learning Outcomes

Left-sided heart failure occurs as a result of inefficient pumping of the left side of the heart, causing fluid buildup in the pulmonary system. Therefore, left-sided HF is most associated with pulmonary symptoms which include pulmonary edema which results in coughing pink-tinged frothy sputum and increasing shortness of breath. Other left sided HF symptoms include dry, hacking cough, paroxysmal nocturnal dyspnea, exertional dyspnea, and orthopnea. Cardiogenic causes of pulmonary edema are due to poor heart function and result in congestive heart failure. Other causes (non-cardiogenic) are from acute respiratory distress syndrome, trauma, kidney failure, and other causes.

Test Taking Tip

Think “Left” heart failure stands for “Lung” signs and symptoms.

Video Rationale