A CHO/Nurse is caring for a patient with Right-Sided Heart Failure. Which of the following conditions would the CHO/Nurse expect?

Appeared in: MP CHO -2021 (Shift 1st)

Explanation

In right-sided heart failure, the right ventricle's inability to pump blood effectively to the lungs causes blood to back up in the systemic venous system.
This systemic venous congestion increases the pressure within the capillaries, forcing fluid out into the interstitial tissues.
The accumulation of this fluid in the dependent parts of the body, such as the legs, ankles, and feet, manifests as peripheral edema, a hallmark sign of right-sided heart failure.

Option B: Decreased urinary output can occur in both right- and left-sided heart failure due to reduced overall cardiac output and kidney perfusion. It is not a specific distinguishing feature of right-sided failure compared to peripheral edema.
Option C: Shortness of breath (dyspnea) is the classic symptom of left-sided heart failure. It results from pulmonary congestion as blood backs up from the failing left ventricle into the lungs.
Option D: Seizure activity is not a typical or direct symptom of heart failure. It is a neurological event and would only be a potential complication in extreme, late-stage heart failure causing severe cerebral hypoxia or metabolic derangement.

Clinical Relevance

Nursing practice connection: Use the key finding related to Clinical manifestations of Right-Sided Heart Failure to guide bedside assessment, documentation, and the next nursing action.
Accurate assessment of heart failure symptoms is critical for nurses to determine the type and severity of the condition, guiding appropriate interventions.
Key nursing interventions for a patient with peripheral edema from right-sided heart failure include daily weight monitoring, assessing for pitting edema, elevating the lower extremities, and administering diuretics as prescribed.
A low-sodium diet is essential to help manage fluid retention and reduce the workload on the heart.

How to Approach the Question

First, identify the core condition mentioned in the question stem: 'Right-Sided Heart Failure'.
Recall the basic pathophysiology: The right ventricle fails, so blood backs up into the body's systemic venous circulation.
Think about the consequences of systemic venous congestion. Increased pressure in the veins will cause fluid to leak out into tissues.
Evaluate the options based on this pathophysiology. 'Peripheral Edema' is a direct result of fluid leaking into the tissues of the extremities.
Eliminate options that don't fit. 'Shortness of Breath' is related to lung (pulmonary) congestion, which is characteristic of left-sided failure. 'Decreased urinary output' is too general, and 'Seizure activity' is not a typical cardiac symptom.

Concept Tested & Keywords

Q8IHuwcHrix_hLBIVRqQ20

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 3 p. 29-31

E6 Physiology Guyton 4SAE Part 2A pp. 20-22, 21-23

Practise the full MP CHO -2021 (Shift 1st)

Attempt every question from this paper in a timed mock, then review the full solution for each one.