Question

Which finding would cause the nurse to suspect a patient with heart failure was experiencing end organ hypoperfusion?

1. Confusion
2. Dropping blood pressure
3. Urine output 15 mL per hour
4. Heart rate 124
5. Peripheral edema

Answer 1

A urine output of 15 mL per hour is the finding that most strongly suggests end-organ hypoperfusion in a patient with heart failure, as it indicates insufficient renal perfusion. Normal urine output should be at least 1 mL/kg body weight/hour.

Step-by-step explanation:

Among the options provided, a urine output of 15 mL per hour would be a significant finding that would cause a nurse to suspect a patient with heart failure was experiencing end-organ hypoperfusion. In circulatory shock, including that which results from heart failure, inadequate blood flow fails to provide sufficient oxygen and nutrients to maintain cellular metabolism. This can lead to a decrease in urine output, which is a critical indicator of kidney function. Normal urine output is generally considered to be at least 1 mL/kg body weight/hour. Therefore, a urine output of 15 mL per hour is cause for concern and indicates that the kidneys may not be receiving enough perfusion.

Dropping blood pressure also indicates hypoperfusion, but this is not the most immediate indicator of end-organ damage. Confusion could be a sign of brain hypoperfusion, but it is less specific than urine output since confusion can result from many other factors as well. A heart rate of 124 (tachycardia) and peripheral edema are signs of heart failure but do not directly indicate organ hypoperfusion; rather, they are reflections of the compensatory mechanisms and consequences of heart failure.