1 Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc. Nursing Management: Heart Failure Chapter 35

2 Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc. 1.A patient with a history of chronic heart failure is hospitalized with severe dyspnea and a dry, hacking cough. She has pitting edema in both ankles, and her vital signs are blood pressure 170/100 mm Hg, pulse 92 beats/min, and respirations 28 breaths/min. The nurse recognizes that the patient’s symptoms indicate 1.that venous return to the heart is impaired, causing a decrease in cardiac output. 2.impaired emptying of both the right and left ventricles, with low forward blood flow. 3.the right side of the heart is failing to pump enough blood to the lungs to provide systemic oxygenation. 4.the myocardium is not receiving enough blood supply through the coronary arteries to meet its oxygen demand.

3 Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc. 2.A patient with left-sided heart failure has oxygen at 4 L/min per nasal cannula, furosemide (Lasix) 40 mg PO daily, spironolactone (Aldactone) 25 mg PO daily, and enalapril (Vasotec) 5 mg PO twice daily. Which of the following actions is most important for the nurse to carry out? 1.Assess skin turgor 2.Auscultate lung sounds 3.Measure intake and output 4.Draw a blood sample for arterial blood gases

4 Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc. 3.A patient with chronic heart failure who is taking digoxin (Lanoxin) 0.25 mg PO daily with furosemide (Lasix) 60 mg PO daily develops nausea and vomiting. The home care nurse should 1.notify the health care provider. 2.perform a dipstick urine test for protein. 3.instruct the patient to increase intake of high-potassium foods. 4.ask the patient to weigh each morning and call the nurse in 3 days.