The nurse is assessing a newly admitted client diagnosed with left ventricular failure.
Which of the following findings should the nurse expect during the assessment?

Choice A rationale

A low-sodium, high-calorie diet is not the priority for immediate management of renal colic. Nutritional changes are addressed as part of long-term care but do not alleviate acute pain and discomfort caused by obstruction or irritation in the urinary tract.

Choice B rationale

Increasing fluid intake of 3 to 4 L/day is beneficial for preventing stone formation and enhancing urinary output, but fluid intake changes alone do not address acute renal colic. The urgency lies in alleviating the pain and promoting ureteral relaxation.

Choice C rationale

Tamsulosin (Flomax) 0.4 mg p.o. daily relaxes smooth muscles in the ureter, aiding stone passage, but does not provide immediate pain relief. It is a supportive measure rather than a first-line intervention during acute renal colic.

Choice D rationale

Morphine sulfate (Morphine) 2 mg IV every 4 hours PRN is the correct choice, as it addresses severe pain due to renal colic by acting directly on opioid receptors to block pain transmission. Pain relief improves the client’s comfort and allows further management strategies.

Choice A rationale

Right-sided heart failure with thickened heart muscle refers specifically to the impaired filling capacity due to diastolic dysfunction. Diastolic dysfunction affects the filling phase, not the pumping phase. It may involve one side or both sides but is not explicitly described as right and left-sided diastolic in this context.

Choice B rationale

Right-sided systolic heart failure affects the pumping ability, while diastolic affects filling. Both conditions together do not explain the thickened myocardium impairing filling. A combination of systolic and diastolic failure typically includes both pumping and filling abnormalities rather than isolated thickening with poor filling.

Choice C rationale

Right-sided diastolic failure results from impaired ventricular relaxation and thickened myocardium, leading to reduced filling capacity. This type of failure involves the heart's inability to accommodate blood during diastole, consistent with the description of thickened heart muscle and poor filling on the right side.

Choice D rationale

Right-sided systolic failure involves impaired contractility and pumping of blood to the lungs, not poor filling caused by thickened muscle. Systolic dysfunction decreases the heart's output rather than affecting the filling phase described in this scenario.