A patient was admitted for terminal heart failure and is now eligible for a transplant. The family wants everything possible done to maintain life. Which procedure might be offered to the patient for this condition to increase the patient's quality of life?
Coronary artery bypass graft
Percutaneous coronary artery intervention
Nothing, because the patient is in terminal heart failure
Left ventricular assist device (LVAD)
The Correct Answer is D
Rationale:
A. A coronary artery bypass graft is used to treat coronary artery disease but is not typically indicated for end-stage heart failure.
B. Percutaneous coronary intervention is also used for coronary artery disease, not for improving quality of life in terminal heart failure.
C. This option dismisses potential interventions that could improve quality of life, such as an LVAD.
D. An LVAD is a mechanical pump that assists the left ventricle in pumping blood, often used as a bridge to heart transplant or as a long-term solution to improve quality of life in patients with terminal heart failure.
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Correct Answer is ["B","C","E"]
Explanation
Rationale:
A. Crackles are more commonly associated with left ventricular failure, which leads to pulmonary congestion.
B. Hepatomegaly, or an enlarged liver, is a sign of right ventricular failure due to blood backing up in the systemic circulation.
C. Jugular venous distention is a classic sign of right ventricular failure as blood accumulates in the venous system.
D. Orthopnea, or difficulty breathing while lying down, is more indicative of left ventricular failure.
E. Peripheral edema is a hallmark of right ventricular failure, resulting from increased venous pressure.
Correct Answer is A
Explanation
Rationale:
A. Clustering nursing activities helps to minimize interruptions, allowing the patient to have longer periods of uninterrupted rest, which is essential for recovery and reducing sensory disturbances from sleep deprivation.
B. Silencing alarms could compromise patient safety and is not recommended.
C. Administering sedatives or opioids should be done cautiously and is not a first-line approach for promoting sleep, especially if non-pharmacological methods can be effective.
D. While reducing nighttime assessments may help with sleep, it is not always feasible and should be balanced with the need for monitoring the patient’s condition.