The nurse is assessing a patient who is known to have left-sided HF. What assessment finding is not most consistent with this patient’s diagnosis?
A Distended neck veins.
B Orthopnea.
C Pulmonary edema.
D Dry cough.
The correct answer and explanation is:
The correct answer is A: Distended neck veins.
Explanation:
Left-sided heart failure (HF) occurs when the left ventricle cannot effectively pump blood to the body, leading to a backup of blood in the pulmonary circulation. This results in pulmonary symptoms such as orthopnea, pulmonary edema, and dry cough.
- Orthopnea (B) is a common symptom of left-sided HF. It refers to difficulty breathing while lying flat, which occurs because blood from the body backs up into the lungs when the patient is in a supine position, making it harder for the lungs to oxygenate the blood.
- Pulmonary edema (C) is another hallmark of left-sided HF. It happens when fluid accumulates in the alveoli of the lungs due to the backup of blood, leading to shortness of breath, crackles on auscultation, and sometimes a frothy sputum. This can severely impair gas exchange and oxygen delivery to the body.
- Dry cough (D) can also be seen in patients with left-sided HF. It often occurs due to fluid buildup in the lungs, which irritates the airways, causing a non-productive cough. The patient may also report feelings of tightness in the chest.
On the other hand, distended neck veins (A) are more characteristic of right-sided heart failure, not left-sided HF. In right-sided heart failure, the right ventricle struggles to pump blood to the lungs, causing blood to back up into the systemic circulation. This leads to symptoms like peripheral edema, jugular vein distention, and hepatomegaly. While left-sided HF can eventually lead to right-sided failure if untreated, distended neck veins are not a direct result of left-sided heart failure.
Therefore, the presence of distended neck veins would not be most consistent with left-sided heart failure.