Chapter 38 Heart Failure

A patient who has dyspnea has been diagnosed with early left ventricular heart failure (HF). In which order would the nurse expect changes associated with left ventricular HF to occur?

1. 1. Ineffective ventricular contractility

2. 2. Elevated pressure in the left atrium

3. 3. Fluid leaking into interstitial spaces

4. 4. Inadequate alveolar gas exchange

Which assessment findings would indicate a patient with chronic heart failure has developed acute decompensated heart failure (ADHF)?

Severe dyspnea and blood-streaked, frothy sputum

At a clinic visit, the nurse provides diet teaching for a patient recently hospitalized with an exacerbation of chronic heart failure. The nurse determines that teaching is successful if the patient makes which statement?

"I will limit the amount of milk and cheese in my diet."

The nurse is preparing to administer digoxin to a patient with heart failure (HF). Laboratory results include the following findings: sodium 139 mEq/L, potassium 5.6 mEq/L, chloride 103 mEq/L, and glucose 106 mg/dL. What is the priority action by the nurse?

Withhold the dose and report the potassium level.

The nurse is caring for a patient with acute decompensated heart failure (HF). What compensatory mechanism in acute decompensation heart failure (HF) leads to fluid retention and edema?

renin-angiotensin-aldosterone activation

A patient with a recent diagnosis of heart failure (HF) has been prescribed furosemide. Which outcome would demonstrate medication effectiveness?

Reduced preload

A patient with chronic heart failure (HF) and atrial fibrillation asks the nurse why an anticoagulant has been prescribed to continue at home. Which response would the nurse provide?

"The medication prevents blood clots from forming in your heart."

After having a myocardial infarction (MI), a patient has jugular venous distention (JVD), weight gain, peripheral edema, and a heart rate of 108 beats/min. Which type of heart failure (HF) would the nurse suspect?

Right-sided HF

The nurse is administering a dose of digoxin to a patient with heart failure (HF). The nurse would become concerned with the possibility of digitalis toxicity if the patient reported which symptom?

Loss of appetite

The nurse prepares to administer digoxin to a patient admitted with influenza and a history of chronic heart failure (HF). Which result would the nurse review before giving the medication?

Serum potassium level

The patient with chronic heart failure (HF) is being discharged from the hospital. Which information would the nurse emphasize to prevent progression of the disease to acute decompensated heart failure (ADHF)?

Take medications as prescribed.

A patient who had bladder surgery 2 days ago develops acute decompensated heart failure (ADHF) with severe dyspnea. Which action by the nurse would be indicated first?

Assist the patient to a sitting position with arms on the overbed table.

Which nursing actions is the priority when caring for a patient receiving support with an intraaortic balloon pump (IABP)?

Assess peripheral pulses in the lower extremities

The nurse is reviewing the medication list of a patient with systolic heart failure (reduced ejection fraction). Which medications would the nurse expect to administer as part of the 4 pillars of drug therapy for heart failure? (Select all that apply.)

Lisinopril

Dapagliflozin

Spironolactone

Sacubitril/valsartan

Metoprolol succinate

A patient with a long-standing history of heart failure (HF) recently qualified for hospice care. Which measure would the nurse now prioritize when providing care for this patient?

Choose interventions to promote comfort and prevent suffering.

The nurse is caring for a patient newly diagnosed with heart failure. The patient is to receive a first dose of digoxin 0.125 mg IV push. An ampule containing 0.25 mg/mL is available. Calculate the number of milliliters the nurse would draw up to administer this dose

0.5

Which information would the nurse provide to a patient about the use of a nitroglycerin patch?

Avoid drugs to treat erectile dysfunction.

An asymptomatic patient with acute decompensated heart failure (ADHF) suddenly becomes dyspneic. Before dangling the patient on the bedside, what would the nurse assess first?

Blood pressure

Which nursing intervention is most important caring when for a patient with a left ventricular assist device?

Assess for signs of bleeding and infection at the insertion site

Which finding would the nurse recognize as an indication for the use of dopamine in the care of a patient with heart failure (HF)?

Hypotension and tachycardia

A patient admitted with heart failure (HF) is anxious and reports shortness of breath. Which actions would the nurse take? (Select all that apply.)

Administer prescribed morphine sulfate.

Place patient in a semi-Fowler's position.

Instruct patient on the use of relaxation techniques.

Use a calm, reassuring approach while talking to patient.

A patient is scheduled for a heart transplant. What is the major cause of death beyond the first year after a heart transplant?

Cardiac vasculopathy