{"id":263130,"date":"2025-07-21T04:55:32","date_gmt":"2025-07-21T04:55:32","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=263130"},"modified":"2025-07-21T04:55:34","modified_gmt":"2025-07-21T04:55:34","slug":"after-receiving-change-of-shift-report-on-four-patients-admitted-to-a-heart-failure-unit","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2025\/07\/21\/after-receiving-change-of-shift-report-on-four-patients-admitted-to-a-heart-failure-unit\/","title":{"rendered":"After receiving change-of-shift report on four patients admitted to a heart failure unit"},"content":{"rendered":"\n

After receiving change-of-shift report on four patients admitted to a heart failure unit, which patient should the nurse assess first? <\/p>\n\n\n\n

1. A patient who reported dizziness after receiving the first dose of captopril <\/p>\n\n\n\n

2. A patient who is cool and clammy, with new-onset confusion and restlessness <\/p>\n\n\n\n

3. A patient who has crackles bilaterally in the lung bases and is receiving oxygen. <\/p>\n\n\n\n

4. A patient who is receiving IV nesiritide (Natrecor) and has a blood pressure of 100\/62<\/p>\n\n\n\n

The correct answer and explanation is:<\/mark><\/strong><\/p>\n\n\n\n

The nurse should assess the second patient<\/strong> first, the one who is cool and clammy, with new-onset confusion and restlessness<\/strong>.<\/p>\n\n\n\n

Explanation:<\/strong>
This patient’s symptoms\u2014cool and clammy skin, confusion, and restlessness\u2014suggest signs of acute deterioration<\/strong> and possibly hypoperfusion<\/strong>. The restlessness and confusion may indicate a decreased oxygen supply to the brain<\/strong> or decreased cardiac output<\/strong>, both of which are critical in heart failure patients. These symptoms could signal shock<\/strong>, particularly if related to poor cardiac output or hypovolemia, which requires immediate intervention.<\/p>\n\n\n\n

The other patients, while requiring attention, do not present with the same level of urgency:<\/p>\n\n\n\n

    \n
  1. A patient who reported dizziness after receiving the first dose of captopril<\/strong>: Although dizziness can occur with captopril due to its vasodilatory effect<\/strong>, this is typically more of a transient side effect and may not be as immediately life-threatening as signs of hypoperfusion. It is important to monitor this patient closely, but they do not need to be assessed first.<\/li>\n\n\n\n
  2. A patient who has crackles bilaterally in the lung bases and is receiving oxygen<\/strong>: Crackles suggest pulmonary edema<\/strong>, which is a common issue in heart failure patients. While the patient needs monitoring and treatment, they are already receiving oxygen, which indicates that their respiratory needs are being managed.<\/li>\n\n\n\n
  3. A patient who is receiving IV nesiritide (Natrecor) and has a blood pressure of 100\/62<\/strong>: Although this patient’s blood pressure is lower than normal, IV nesiritide<\/strong> is often used to help manage acute heart failure by reducing preload and afterload<\/strong>. A blood pressure of 100\/62 is not immediately alarming, but it does warrant monitoring.<\/li>\n<\/ol>\n\n\n\n

    In summary, the patient with signs of poor perfusion or shock (cool and clammy, confusion, and restlessness) is the most critical and should be assessed first.<\/p>\n","protected":false},"excerpt":{"rendered":"

    After receiving change-of-shift report on four patients admitted to a heart failure unit, which patient should the nurse assess first? 1. A patient who reported dizziness after receiving the first dose of captopril 2. A patient who is cool and clammy, with new-onset confusion and restlessness 3. A patient who has crackles bilaterally in the […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-263130","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/263130","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=263130"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/263130\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=263130"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=263130"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=263130"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}