Question

While transferring a patient with heart failure from the bed to a chair the nurse stops and decides to keep the patient in bed. What patient manifestations indicated to the nurse this patient's status was deteriorating?

1. Respiratory rate 30
2. Heart rate 134 on the cardiac monitor
3. Gasping for breath
4. Productive cough
5. Jugular vein distention

Answer 1

The nurse decided to keep the patient in bed while transferring them to a chair due to manifestations of deteriorating status. Symptoms such as increased heart rate, respiratory distress, and jugular vein distention indicate worsening heart failure. The decision was made for further evaluation and intervention.

Step-by-step explanation:

The nurse decided to keep the patient in bed while transferring them to a chair. The nurse made this decision because the patient showed manifestations of deteriorating status, including a respiratory rate of 30, a heart rate of 134 on the cardiac monitor, gasping for breath, productive cough, and jugular vein distention. These symptoms indicate that the patient's heart failure may be worsening, and it would be safer to keep them in bed for further evaluation and intervention.