A patient is diagnosed with chronic obstructive pulmonary disease (COPD) and has elevated pulmonary vascular resistance. Which complications would the health care professional assess the patient for?
Left heart failure
Restrictive cardiomyopathy
Hypertrophic cardiomyopathy
Right heart failure
The Correct Answer is D
A. Left heart failure: COPD primarily affects the lungs and increases pulmonary vascular resistance, leading to right-sided heart strain rather than left heart failure. Left heart failure is more commonly associated with conditions such as hypertension, myocardial infarction, and valvular diseases, which impair the heart’s ability to pump blood systemically.
B. Restrictive cardiomyopathy: Restrictive cardiomyopathy is a condition where the heart muscle becomes stiff and loses its ability to relax and fill properly, often due to infiltrative diseases such as amyloidosis or sarcoidosis. COPD does not directly lead to restrictive cardiomyopathy, as its primary cardiovascular complication is increased pulmonary resistance causing right heart strain.
C. Hypertrophic cardiomyopathy: Hypertrophic cardiomyopathy is characterized by abnormal thickening of the heart muscle, usually due to genetic mutations. It primarily affects the left ventricle and impairs diastolic filling. COPD does not cause hypertrophic cardiomyopathy, as its cardiovascular effects are due to pulmonary hypertension and right ventricular overload rather than structural abnormalities of the myocardium.
D. Right heart failure: Chronic COPD leads to persistent pulmonary hypertension due to hypoxic vasoconstriction and remodeling of pulmonary vessels. This increased pulmonary vascular resistance forces the right ventricle to work harder to pump blood into the lungs, leading to right ventricular hypertrophy and eventual right heart failure, also known as cor pulmonale. Symptoms include peripheral edema, jugular vein distention, and hepatomegaly due to systemic venous congestion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. By causing dysrhythmias as a result of hyperkalemia: Angiotensin II does not directly cause dysrhythmias through hyperkalemia. While hyperkalemia can lead to dysrhythmias, angiotensin II primarily acts as a vasoconstrictor and does not directly influence potassium levels.
B. By increasing peripheral vasoconstriction: Angiotensin II increases peripheral vascular resistance through vasoconstriction, which raises blood pressure. This increased resistance requires the heart to work harder to pump blood, thereby increasing the workload on the heart following a myocardial infarction.
C. By stimulating the sympathetic nervous system: Angiotensin II does stimulate the sympathetic nervous system, which can increase heart rate and contractility; however, the direct effect on increasing workload is more prominently due to peripheral vasoconstriction.
D. By reducing the contractility of the myocardium: Angiotensin II does not reduce contractility; in fact, it can enhance contractility in some contexts. It primarily increases the workload of the heart through vasoconstriction and increased afterload rather than reducing contractility.
Correct Answer is D
Explanation
A. Veins that are most susceptible to a deep vein thrombosis are the peroneal, posterior tibial, popliteal and superficial femoral: This statement is correct. These veins are indeed among the most common sites for the development of DVT.
B. DVTs tend to mostly occur in the lower extremities but can occur in the upper extremities too: This statement is also correct. While DVTs primarily occur in the lower extremities, they can occur in the upper extremities as well, particularly in individuals with risk factors such as central venous catheters or certain medical conditions.
C. A DVT is a type of venous thromboembolism (VTE), which is a blood clot that starts in the vein: This statement is correct. DVTs are indeed classified as venous thromboembolism, which refers to blood clots that form in the venous system.
D. A deep vein thrombosis in the lower extremity has a low probability of becoming a pulmonary embolism: This statement is incorrect. A deep vein thrombosis in the lower extremity has a significant risk of becoming a pulmonary embolism if a thrombus dislodges and travels to the pulmonary circulation. It is essential to monitor and treat DVTs to reduce the risk of complications like pulmonary embolism.
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