Which compensatory mechanism is involved in both chronic heart failure and decompensated heart failure, leading to fluid retention and edema?

Increased systemic blood pressure

Renin-angiotensin-aldosterone activation

Ventricular hypertrophy

Ventricular dilation

Answer and Explanation

The Correct Answer is B

A. Increased systemic blood pressure – While systemic vasoconstriction may occur to maintain perfusion, it is a result of compensatory mechanisms like RAAS, not a primary mechanism leading to fluid retention and edema.

B. Renin-angiotensin-aldosterone activation – RAAS leads to:

Sodium and water retention via aldosterone

Vasoconstriction via angiotensin II

These changes increase intravascular volume, contributing to fluid overload and edema.

C. Ventricular hypertrophy – This is a structural adaptation to increased workload (pressure overload), not directly responsible for fluid retention.

D. Ventricular dilation – Dilation occurs as a result of chronic volume overload, not as a compensatory mechanism causing fluid retention.

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Correct Answer is A

Explanation

A. Ischemia and neuronal death – Cerebral perfusion pressure (CPP) is the pressure needed to ensure adequate blood flow to the brain. If CPP drops too low, the brain doesn't receive enough oxygen and glucose, leading to ischemia and eventually neuronal death.
B. Improved cognitive function – Low CPP results in decreased oxygen and nutrient delivery, which impairs cognitive and neurological function.
C. Increased blood flow to the brain – Low CPP means reduced blood flow, not increased.
D. Undetectable intracranial glucose levels – While glucose delivery may decrease, levels are not necessarily undetectable and this is not the primary concern with low CPP.

A. If you weigh yourself after breakfast, subtract what you ate from your weight. B. walking and other activities should be done gradually, provided they do not cause dyspnea. C. Notify the provider of a weight loss of 0.1 kg (1 lb) in a week. D. Consistency doesn't matter when you weigh yourself, as long as you weigh yourself once every few weeks.

Correct Answer is B

Explanation

A. Weight should be measured consistently at the same time each day, ideally in the morning before eating, to accurately monitor fluid retention; subtracting food weight is not practical or accurate.
B. Gradual increase in activity is important for clients with heart failure, as long as it does not cause shortness of breath (dyspnea). This helps improve functional capacity safely.
C. A weight loss of 0.1 kg (1 lb) is not usually concerning; rapid weight gain (e.g., 2-3 pounds in a day or 5 pounds in a week) is more significant and should be reported.
D. Consistency in timing and frequency of weighing is critical; daily weighing at the same time helps detect fluid retention early.

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Which compensatory mechanism is involved in both chronic heart failure and decompensated heart failure, leading to fluid retention and edema?

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