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 A
Explanation
A. We will have to drain the pus out of your pleural space: An empyema is characterized by the accumulation of pus in the pleural space, typically due to infection or inflammation. The primary treatment often involves draining the infected fluid to relieve symptoms and treat the underlying infection, making this statement accurate and appropriate for the patient.
B. These blebs in your lungs can rupture with exercise: This statement is not applicable to empyema. Blebs are associated with conditions like pulmonary bullae or emphysema, not empyema. Empyema specifically refers to pus in the pleural space, not blebs in the lungs.
C. You will be given a long course of antiviral medication: Antiviral medication is not typically indicated for empyema, as it is often caused by bacterial infections. Treatment usually involves antibiotics and drainage rather than antiviral therapy.
D. We will watch you for respiratory muscle fatigue: While monitoring for respiratory status is important in any patient with empyema, this statement does not specifically address the nature of empyema or its treatment. The focus should be on managing the infection and drainage of the pleural space.
Correct Answer is A
Explanation
A. Deep vein thrombosis: Patients with deep vein thrombosis (DVT) are at a significantly higher risk for developing pulmonary embolism (PE) due to the potential for thrombus formation in the veins to dislodge and travel to the lungs. Assessing this patient as a priority is crucial, as timely intervention can prevent the development of PE.
B. Endocarditis: While endocarditis can lead to embolic events, it typically results in systemic emboli rather than specifically causing pulmonary embolism. The immediate priority for PE assessment is lower in patients with endocarditis compared to those with DVT.
C. Left heart failure: Left heart failure can lead to pulmonary congestion and respiratory symptoms but does not directly indicate a high risk of pulmonary embolism. While it is important to monitor these patients, assessing for PE is not the immediate priority.
D. Valvular disease: Valvular disease can increase the risk of thrombus formation, particularly if it results in atrial fibrillation. However, the direct connection to pulmonary embolism is not as pronounced as in patients with DVT. Therefore, assessing patients with valvular disease for PE is not the priority compared to those with DVT.
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