A nurse is collecting data from a client who has left-sided heart failure. Which of the following findings should the nurse expect?
Shortness of breath while lying down
Jugular venous distention
Right upper quadrant pain
Pitting edema of the lower legs
The Correct Answer is A
A. Shortness of breath while lying down. Shortness of breath when lying down, or orthopnea, is common in left-sided heart failure due to fluid backing up into the lungs, causing pulmonary congestion.
B. Jugular venous distention. Jugular venous distention is more commonly associated with right-sided heart failure due to systemic venous congestion.
C. Right upper quadrant pain. Right upper quadrant pain is associated with liver congestion due to right-sided heart failure, not left-sided heart failure.
D. Pitting edema of the lower legs. Pitting edema is a symptom of right-sided heart failure, as fluid backs up into the peripheral circulation.
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Correct Answer is D
Explanation
A. Depression: While propranolol can sometimes worsen symptoms of depression, this is not as critical as the impact on conditions like heart failure.
B. Glaucoma: Propranolol does not typically affect glaucoma; however, some beta-blockers are used to treat glaucoma.
C. Migraine: Propranolol is sometimes used to prevent migraines, so a history of migraines would not require discontinuation.
D. Heart failure: Propranolol can exacerbate heart failure by reducing myocardial contractility. Clients with heart failure require careful monitoring or an alternative medication.
Correct Answer is ["A","C","E"]
Explanation
A. "This medication can make me have mood swings." Beta blockers can cause mood changes, such as depression or mood swings, as a side effect.
B. "I may have urinary incontinence while taking this medication." Urinary incontinence is not a common side effect of beta blockers.
C. "I should not drive while taking this new medication." Beta blockers can cause dizziness or fatigue, so clients should avoid driving until they know how the medication affects them.
D. "I may have frequent hiccups while taking this medication." Hiccups are not a common side effect of beta blockers.
E. "This new medication may decrease my sex drive." Beta blockers can sometimes cause decreased libido as a side effect.