Patho Patho #93

Question

A client admitted with an exacerbation of congestive heart failure (CHF) will have the goals to:

Answers

  1. Increase preload, increase afterload, decrease cardiac output.
    • Rationale:

      This answer choice is not correct because the goals include reduction of preload and afterload and increasing cardiac output.

  2. Decrease preload, decrease afterload, decrease cardiac output.
    • Rationale:

      This answer choice is not correct because the goals include reduction of preload and afterload and increasing cardiac output.

  3. Increase preload, increase afterload, increase cardiac output.
    • Rationale:

      This answer choice is not correct because the goals include reduction of preload and afterload and increasing cardiac output.

  4. Decrease preload, decrease afterload, increase cardiac output.
    • Rationale:

      This answer is correct because goals for clients with CHF include reduction of preload and afterload and increasing cardiac output.

Overview

The focus of this question is asking the nurse to identify the appropriate goals for a client admitted for treatment of exacerbation of congestive heart failure. Congestive heart failure results from a heart that is not pumping forward adequately enough to perfuse the body/ lungs. The goals for these clients are to decrease preload (venous return), afterload (resistance the heart must overcome in order to pump effectively), and increase cardiac output.

Explanation

Learning Outcomes

Congestive heart failure affects the contractility of the heart which results in decreased systemic perfusion if the right side of the heart is affected. If the left side of the heart is affected, the lungs will not be adequately perfused, thus negatively affecting oxygenation. Preload refers to the amount of blood returning to the right side of the heart. Afterload refers to the force that the heart must overcome in order to pump forward and is determined by vascular resistance. Goals for CHF clients are to reduce both preload and afterload and increase cardiac output.

Test Taking Tip

Preload= venous return to the right side of the heart. This is reduced by administration of diuretics. Afterload= the force the heart must work against to pump. This is reduced by administration of vasodilators.

Video Rationale