A patient with cirrhosis is scheduled for a TIPS procedure. Which of the following correctly describes a TIPS procedure?

A. An increase in O2 saturation to greater than 90%: An increase in oxygen saturation is typically a positive sign and does not indicate worsening heart failure.

B. The onset of atrial fibrillation: The development of atrial fibrillation in a patient with heart failure is a sign of worsening heart failure, as it indicates increased atrial pressure and the potential for further hemodynamic compromise.

C. Louder S1 and S2 heart sounds: Louder heart sounds do not specifically indicate worsening heart failure. They may vary based on other factors such as body habitus or the position of the patient.

D. A decrease in heart rate to 66 bpm: A heart rate of 66 bpm is within the normal range and does not suggest worsening heart failure.

A. Patient stopped smoking five years prior to hospitalization: Smoking cessation materials are typically targeted to current smokers or those who have quit very recently (usually within the last year). This patient may not need smoking cessation materials as they have been smoke-free for a significant period.

B. Patient smokes five cigars a week: Smoking cigars still carries health risks similar to cigarettes and indicates the need for smoking cessation materials.

C. Patient uses chewing tobacco: Chewing tobacco is a form of smokeless tobacco, and while harmful, it would require different educational materials focused on smokeless tobacco cessation rather than smoking cessation.

D. Patient smoked cigarettes any time during the last year prior to hospitalization: This indicates current or recent smoking behavior which is a significant risk factor that needs to be addressed.