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Exam (elaborations)

Congestive Heart FailureVCHF success

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.The client is admitted to the telemetry unit diagnosed with acute exacerbation of congestive heart failure (CHF). Which signs/symptoms would the nurse expect to find when assessing this client 1. Apical pulse rate of 110 and 4pitting edema of feet. 2. 2. Thick white sputum and crackles that clear with cough. 3. 3. The client sleeping with no pillow and eupnea. 4. 4. Radial pulse rate of 90 and capillary refill time <3 seconds. 2.The nurse is developing a nursing care plan for a client diagnosed with congestive heart failure. A nursing diagnosis of “decreased cardiac output related to inability of the heart to pump effectively” is written. Which short-term goal would be best for the clientThe client will: 1. Be able to ambulate in the hall by date of discharge. 2. Have an audible S1 and S2 with no S3 heard by end of shift. 3. Turn, cough, and deep breathe every two (2) hours. 4. Have a pulse oximeter reading of 98% by day two (2) of care.

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