Anasarca is a feature of?

DSSSB - 28 August 2019 (Shift-1)

Medical & Surgical Nursing

Easy

Appeared in: DSSSB - 28 August 2019 (Shift-1)

Explanation

Anasarca is severe, generalized body swelling caused by fluid accumulation in the interstitial spaces.
It is a hallmark sign of right-sided heart failure, where the right ventricle's inability to pump blood forward leads to a backup of blood in the systemic venous system.
This systemic venous congestion increases hydrostatic pressure in the capillaries throughout the body, pushing fluid out into the tissues.
Manifestations progress from dependent edema in the feet and ankles to generalized edema affecting the entire body, known as anasarca.

Option A: Cor pulmonale is a specific type of right-sided heart failure caused by chronic lung disease and pulmonary hypertension. While it does lead to the signs of right-sided failure, including anasarca, 'Right-sided heart failure' is the broader and more direct pathophysiological condition responsible for the symptom.
Option C: Pulmonary hypertension is a condition of high blood pressure in the lung arteries. It is a primary cause of cor pulmonale and subsequent right-sided heart failure. However, the anasarca itself is a direct consequence of the heart's failure to handle systemic venous return, not just the high pressure in the pulmonary circuit.
Option D: Left-sided heart failure involves the left ventricle's inability to pump blood to the body. This causes blood to back up into the pulmonary circulation, leading to pulmonary congestion, pulmonary edema, shortness of breath (dyspnea), and coughing. It does not cause systemic generalized edema like anasarca.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical manifestations of heart failure as background academic context rather than a clinical decision trigger.
Recognizing anasarca is a critical nursing assessment finding that indicates severe fluid overload and advanced heart failure, requiring prompt intervention.
Nursing care for a patient with anasarca includes strict intake and output monitoring, daily weight checks (the most sensitive indicator of fluid balance), assessing for pitting edema, measuring abdominal girth, and protecting the fragile, edematous skin from breakdown.
What if? If the patient presented with severe shortness of breath and pink, frothy sputum instead of generalized edema, the priority concern would shift from right-sided to acute left-sided heart failure with pulmonary edema, a medical emergency requiring immediate intervention to improve oxygenation and reduce pulmonary congestion.

How to Approach the Question

First, identify the key term in the question: 'Anasarca'. Understand its definition as severe, generalized edema.
Recall the basic pathway of blood circulation: Body -> Right Atrium -> Right Ventricle -> Lungs -> Left Atrium -> Left Ventricle -> Body.
Reason through the consequences of failure on each side. A failure on the right side will cause a 'traffic jam' of blood returning from the body, leading to systemic fluid backup (edema, JVD, anasarca).
A failure on the left side will cause a 'traffic jam' of blood returning from the lungs, leading to pulmonary fluid backup (pulmonary edema, dyspnea).
Evaluate the options based on this reasoning. Anasarca (systemic edema) directly matches the consequences of right-sided heart failure.

Concept Tested & Keywords

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