Which assessment finding would the nurse expect from a patient with left-sided heart failure?

Pulmonary congestion

Hepatomegaly

Splenomegaly

Gastrointestinal congestion

Answer and Explanation

The Correct Answer is A

A. Pulmonary congestion is a hallmark of left-sided heart failure. When the left ventricle fails to pump effectively, blood backs up into the lungs, causing symptoms like shortness of breath, crackles, and fluid accumulation in the lungs.
B. Hepatomegaly is more commonly associated with right-sided heart failure, as the right side of the heart is unable to effectively pump blood to the lungs, leading to a backup of blood into the systemic circulation, including the liver.
C. Splenomegaly, like hepatomegaly, is typically seen in right-sided heart failure due to the backup of blood in the systemic circulation.
D. Gastrointestinal congestion is more often associated with right-sided heart failure, where blood backs up into the abdominal organs, leading to symptoms like nausea, bloating, and abdominal pain.

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Correct Answer is A

Explanation

A. After a cardiac catheterization, the client is typically required to lie flat for several hours to prevent complications such as bleeding or hematoma formation at the catheter insertion site, especially if the femoral artery was used. This helps ensure the clotting process is not disturbed and reduces the risk of complications.
B. Elevating the head of the bed to 45° is not recommended immediately after a cardiac catheterization, as it could increase pressure at the insertion site, leading to complications. The client should remain flat to avoid stress on the site.
C. Keeping the client NPO (nothing by mouth) for 4 hours is unnecessary unless the client is scheduled for another procedure or if there are concerns about nausea or vomiting. The priority after cardiac catheterization is monitoring the insertion site and ensuring the client remains flat.
D. Keeping the affected leg slightly flexed is not appropriate. The leg should remain straight and immobile to avoid dislodging any clot or causing bleeding at the insertion site.

A. 0.9% normal saline at 50 mL/hr continuous B. Laboratory testing of serum potassium upon admission C. Bumetanide 1 mg IV bolus every 12 hr D. Morphine sulfate 2 mg IV bolus every 2 hr PRN pain

Correct Answer is A

Explanation

A. Administering 0.9% normal saline at 50 mL/hr continuous is not appropriate for a client with acute heart failure. This solution is isotonic and may contribute to fluid overload, which could worsen the heart failure. In acute heart failure, fluids are typically restricted, and intravenous solutions with a lower sodium content or diuretics are preferred to help manage fluid balance.
B. Laboratory testing of serum potassium is appropriate, as monitoring potassium levels is important in clients with heart failure, especially if they are on medications like diuretics, which can lead to electrolyte imbalances.
C. Bumetanide, a loop diuretic, is commonly used to treat fluid retention in heart failure. The prescribed dose of 1 mg IV bolus every 12 hours is appropriate for managing fluid overload.
D. Morphine sulfate can be used for pain management in acute heart failure, as it helps reduce anxiety, decrease preload, and relieve pain. The prescribed dose of 2 mg IV bolus every 2 hours PRN pain is within a reasonable range for pain control.

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Which assessment finding would the nurse expect from a patient with left-sided heart failure?

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