Cardiac bed is prepared for heart disease patients to?

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2021

Explanation

A cardiac bed is prepared to achieve two main goals for patients with heart disease: relieving dyspnea and assisting in recovery.
The upright (High-Fowler's or orthopneic) position maximizes chest and lung expansion, which directly eases the work of breathing and relieves the sensation of dyspnea.
This position also uses gravity to decrease venous return to the heart (reduces preload). This lessens the heart's workload, conserves myocardial oxygen, and supports overall cardiac recovery.
Therefore, the combination of relieving dyspnea and assisting recovery represents the complete purpose of this nursing intervention.

Option A: This is the opposite of the intended effect. The entire purpose of a cardiac bed is to alleviate, not worsen, breathing difficulties.
Option B: While assisting in recovery is a correct goal, this option is incomplete. It misses the immediate and primary purpose of relieving dyspnea, which is a hallmark symptom in acute cardiac distress.
Option C: This term is too general and non-specific. 'Relieving dyspnea' and 'reducing cardiac workload' are the precise physiological goals, which are more accurate than the vague term 'healing'.

Clinical Relevance

Nursing practice connection: Knowing Therapeutic positioning for cardiac patients helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Positioning is a critical, first-line nursing intervention for patients in respiratory distress due to heart failure. It can rapidly improve oxygenation and reduce patient anxiety without waiting for medications to take effect.
Nurses must continuously assess the patient's response, including respiratory rate, oxygen saturation, and comfort level, after placing them in a cardiac bed.
What if the patient is hypotensive? A full High-Fowler's position might be contraindicated as it can decrease blood pressure further. In this case, a modified position like Semi-Fowler's might be used with careful monitoring of vital signs.

How to Approach the Question

First, identify the key term in the question: 'cardiac bed'. Recognize this as a specific therapeutic position, not just a piece of furniture.
Recall the pathophysiology of heart disease, especially heart failure, where patients experience both breathing difficulty (dyspnea) and a compromised heart muscle.
Think about the goals of nursing interventions for this condition: improve breathing and reduce strain on the heart.
Evaluate each option against these two goals. Option A is incorrect. Options B and C are partially correct but incomplete.
Select the option that is most comprehensive and addresses both the respiratory and cardiovascular goals of the intervention. Option D includes both relieving dyspnea and assisting recovery, making it the best choice.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 3 pp. 15-17, 37-39

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