Which assessment finding alerts the nurse to the possibility of decreased cardiac output in the patient who suddenly develops atrial fibrillation?
Increase capillary refill time.
Rumbling heart murmur.
Intermittent claudication.
Jugular venous distension.
The Correct Answer is A
A. An increased capillary refill time suggests reduced perfusion and may indicate decreased cardiac output, which is critical to assess in patients with atrial fibrillation as it can lead to hemodynamic instability.
B. A rumbling heart murmur may suggest valvular disease but is not specifically indicative of decreased cardiac output in this scenario.
C. Intermittent claudication typically indicates peripheral arterial disease and is not a direct sign of decreased cardiac output.
D. Jugular venous distension can indicate fluid overload or right-sided heart failure, but it is not the most direct indicator of decreased cardiac output compared to capillary refill time.
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Related Questions
Correct Answer is D
Explanation
A. Aortic atherosclerosis and mitral insufficiency could lead to some symptoms of congestion but would not fully explain jugular venous distension and liver congestion.
B. Aortic valve stenosis and left heart failure primarily affect left-sided heart function, which typically does not present with jugular venous distension or peripheral edema.
C. Bronchogenic cancer and diaphoresis do not explain the cardiovascular symptoms present in this case.
D. Pulmonic valve stenosis can lead to right heart failure, causing systemic venous congestion, which results in JVD, liver congestion, ascites, and ankle edema, thus accounting for all aspects of the patient's presentation.
Correct Answer is D
Explanation
A. Hypertension may contribute to cardiovascular issues, but it does not typically cause cyanosis or clubbing.
B. Left heart failure often leads to symptoms like dyspnea and fluid retention but does not commonly cause clubbing of the fingers.
C. Aspiration pneumonia may cause respiratory symptoms, but clubbing is more associated with chronic hypoxia, seen in conditions like chronic bronchitis.
D. Chronic bronchitis, often seen in chronic obstructive pulmonary disease (COPD), can cause long-term hypoxia, leading to cyanosis and clubbing of the fingers. A peak flow test can assess respiratory function and airflow limitations associated with chronic bronchitis.
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