Chapter 37: Heart Failure
The nurse is caring for a client with chronic heart failure. Which
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of the following conditions is a cause of chronic heart disease?
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a. Dysrhythmias
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b. Pulmonary embolus
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c. Myocarditis
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d. Congenital heart disease - correct answer✔ ✔ ANS: D
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Congenital heart disease is a cause of chronic heart failure. Dysr
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hythmias, pulmonary embolus, and myocarditis are causes of ac
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ute heart failure.
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The nurse is caring for a client who is receiving IV furosemide a
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nd morphine for the treatment of acute decompensated heart fail
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ure (ADHF) with severe orthopnea. When evaluating the client r
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esponse to the medications, which of the following is the best in
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dicator that the treatment has been effective?
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a. Weight loss of 1 kg overnight b. Hourly urine output greater t
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han 60 mL st st st
c. Reduction in client complaints of chest pain
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,d. Decreased dyspnea with the head of bed at 30 degrees -
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correct answer✔ ✔ ANS: D
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Because the client's major clinical manifestation of ADHF is ort
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hopnea (caused by the presence of fluid in the alveoli), the best i
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ndicator that the medications are effective is a decrease in dyspn
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ea with the head of the bed at 30 degrees. The other assessment
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data also may indicate that diuresis or improvement in cardiac o
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utput has occurred but are not as specific to evaluating this clien
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t's response.
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Which topic will the nurse plan to include in discharge teaching
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for a client with systolic heart failure and an ejection fraction of
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38%? st
a. Need to participate in an aerobic exercise program several tim
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es weekly.
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b. Use of salt substitutes to replace table salt when cooking and
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at the table.
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c. Importance of making a yearly appointment with the primary
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care provider. st st
d. Benefits and adverse effects of angiotensin-
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converting enzyme (ACE) inhibitors. - correct answer✔ ✔
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ANS: D st st
, The core measure for the treatment of heart failure in clients wit
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h a low ejection fraction is to receive an ACE inhibitor to decrea
st st st st st st st st st st st st
se the progression of heart failure. Aerobic exercise may not be
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appropriate for a client with this level of heart failure, salt substi
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tutes are not usually recommended because of the risk of hyperk
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alemia, and the client will need to see the primary care provider
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more frequently than annually.
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The nurse is conducting a health history on a client with heart fa
st st st st st st st st st st st st
ilure. Which of the following conditions in the client's health his
st st st st st st st st st st
tory is a precipitating cause of heart failure?
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a. Hyperthyroidism
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b. Anemia
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c. Hypovolemia
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d. Diabetes - correct answer✔ ✔ ANS: B
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Anemia is a precipitating cause of heart failure. Also, hypovole
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mia and hypothyroidism are precipitating causes. Diabetes is not
st st st st st st st st
a precipitating cause of heart failure.
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A client who has chronic heart failure tells the nurse, "I felt fine
st st st st st st st st st st st st st
when I went to bed, but I woke up in the middle of the night feel
st st st st st st st st st st st st st st st
ing like I was suffocating!" Which of the following information
st st st st st st st st st st
should the nurse document related to this assessment?
st st st st st st st st
The nurse is caring for a client with chronic heart failure. Which
st st st st st st st st st st st
of the following conditions is a cause of chronic heart disease?
st st st st st st st st st st st st
a. Dysrhythmias
st st
b. Pulmonary embolus
st st st
c. Myocarditis
st st
d. Congenital heart disease - correct answer✔ ✔ ANS: D
st st st st st st st st
Congenital heart disease is a cause of chronic heart failure. Dysr
st st st st st st st st st st
hythmias, pulmonary embolus, and myocarditis are causes of ac
st st st st st st st st
ute heart failure.
st st
The nurse is caring for a client who is receiving IV furosemide a
st st st st st st st st st st st st
nd morphine for the treatment of acute decompensated heart fail
st st st st st st st st st
ure (ADHF) with severe orthopnea. When evaluating the client r
st st st st st st st st st
esponse to the medications, which of the following is the best in
st st st st st st st st st st st
dicator that the treatment has been effective?
st st st st st st st
a. Weight loss of 1 kg overnight b. Hourly urine output greater t
st st st st st st st st st st st st
han 60 mL st st st
c. Reduction in client complaints of chest pain
st st st st st st st st
,d. Decreased dyspnea with the head of bed at 30 degrees -
st st st st st st st st st st st
correct answer✔ ✔ ANS: D
st st st st
Because the client's major clinical manifestation of ADHF is ort
st st st st st st st st st
hopnea (caused by the presence of fluid in the alveoli), the best i
st st st st st st st st st st st st
ndicator that the medications are effective is a decrease in dyspn
st st st st st st st st st st
ea with the head of the bed at 30 degrees. The other assessment
st st st st st st st st st st st st st
data also may indicate that diuresis or improvement in cardiac o
st st st st st st st st st st
utput has occurred but are not as specific to evaluating this clien
st st st st st st st st st st st
t's response.
st
Which topic will the nurse plan to include in discharge teaching
st st st st st st st st st st st
for a client with systolic heart failure and an ejection fraction of
st st st st st st st st st st st st
38%? st
a. Need to participate in an aerobic exercise program several tim
st st st st st st st st st st
es weekly.
st st
b. Use of salt substitutes to replace table salt when cooking and
st st st st st st st st st st st st
at the table.
st st st
c. Importance of making a yearly appointment with the primary
st st st st st st st st st st
care provider. st st
d. Benefits and adverse effects of angiotensin-
st st st st st st
converting enzyme (ACE) inhibitors. - correct answer✔ ✔
st st st st st st
ANS: D st st
, The core measure for the treatment of heart failure in clients wit
st st st st st st st st st st st
h a low ejection fraction is to receive an ACE inhibitor to decrea
st st st st st st st st st st st st
se the progression of heart failure. Aerobic exercise may not be
st st st st st st st st st st st
appropriate for a client with this level of heart failure, salt substi
st st st st st st st st st st st
tutes are not usually recommended because of the risk of hyperk
st st st st st st st st st st
alemia, and the client will need to see the primary care provider
st st st st st st st st st st st st
more frequently than annually.
st st st
The nurse is conducting a health history on a client with heart fa
st st st st st st st st st st st st
ilure. Which of the following conditions in the client's health his
st st st st st st st st st st
tory is a precipitating cause of heart failure?
st st st st st st st st
a. Hyperthyroidism
st st
b. Anemia
st st
c. Hypovolemia
st st
d. Diabetes - correct answer✔ ✔ ANS: B
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Anemia is a precipitating cause of heart failure. Also, hypovole
st st st st st st st st st
mia and hypothyroidism are precipitating causes. Diabetes is not
st st st st st st st st
a precipitating cause of heart failure.
st st st st st st
A client who has chronic heart failure tells the nurse, "I felt fine
st st st st st st st st st st st st st
when I went to bed, but I woke up in the middle of the night feel
st st st st st st st st st st st st st st st
ing like I was suffocating!" Which of the following information
st st st st st st st st st st
should the nurse document related to this assessment?
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