Upon admission to the ICU, a client with a history of cor pulmonale will likely be exhibiting which clinical manifestations of right-sided heart failure? Select all that apply. (Select All that Apply.)

A. Expecting copious amounts of frothy, pink sputum: This symptom is typically associated with left-sided heart failure or pulmonary edema, where fluid accumulates in the lungs, leading to the production of frothy, pink sputum. It is not a classic manifestation of right-sided heart failure.

B. Fine crackles throughout both lung fields: Fine crackles are more indicative of left-sided heart failure due to fluid accumulation in the lungs (pulmonary congestion). In right-sided heart failure, the primary issues relate more to systemic congestion rather than pulmonary congestion.

C. +pitting edema in lower extremities: Right-sided heart failure often leads to fluid retention and peripheral edema due to increased venous pressure. Pitting edema in the lower extremities is a common clinical manifestation in patients with cor pulmonale and right-sided heart failure.

D. Altered level of consciousness: This can occur due to decreased cardiac output and resulting reduced cerebral perfusion. In right-sided heart failure, especially in advanced stages, fluid overload can lead to increased intracranial pressure, contributing to altered mental status.

E. Jugular vein distention: Jugular vein distention is a classic sign of right-sided heart failure. Increased pressure in the right atrium due to fluid overload results in distended neck veins, indicating elevated venous pressure.

A. Hypoventilation causes hypocapnia: Hypoventilation leads to inadequate removal of carbon dioxide (CO₂), resulting in hypercapnia rather than hypocapnia. This occurs because decreased ventilation reduces gas exchange efficiency, allowing CO₂ to accumulate in the blood, which can cause respiratory acidosis.

B. Hypoventilation causes alkalosis: Hypoventilation leads to respiratory acidosis rather than alkalosis. When ventilation is insufficient, CO₂ builds up in the bloodstream, leading to an increase in hydrogen ion concentration and a subsequent drop in blood pH. This is commonly seen in conditions like chronic obstructive pulmonary disease (COPD), neuromuscular disorders, and opioid overdose.

C. Hyperventilation causes acidosis: Hyperventilation results in excessive elimination of CO₂, leading to a decrease in hydrogen ion concentration and an increase in blood pH, causing respiratory alkalosis rather than acidosis. Acidosis occurs when CO₂ retention leads to an increase in hydrogen ion concentration, which is the opposite of what happens with hyperventilation.

D. Hyperventilation causes hypocapnia: Hyperventilation leads to an excessive exhalation of CO₂, causing a reduction in blood CO₂ levels (hypocapnia). This can result in respiratory alkalosis, leading to symptoms such as dizziness, lightheadedness, tingling sensations, and even syncope. It is often seen in conditions like anxiety, panic attacks, fever, or high-altitude exposure.