Question

You are assessing a 70-year-old male who complains of pain in both of his legs. He is conscious and alert, has a blood pressure of 160/90 mm Hg, a pulse rate of 110 beats/min, and respirations of 14 breaths/min and unlabored. Further assessment reveals edema to both of his feet and legs and jugular venous distention. This patient's primary problem is MOST likely:

a) Acute arterial occlusion
b) Acute coronary syndrome
c) Acute heart failure
d) Aortic aneurysm

Answer 1

The 70-year-old male patient with bilateral leg pain, jugular venous distention, and bilateral edema most likely suffers from acute heart failure, indicated by the presence of jugular venous distention and edema which are classic signs of heart failure.

Step-by-step explanation:

A 70-year-old male patient with complaints of pain in both legs, jugular venous distention, and bilateral edema in the feet and legs likely has a primary problem of acute heart failure. The elevated blood pressure and tachycardia can be compensatory mechanisms for heart failure. Edema is commonly caused by the heart's inability to pump blood effectively, leading to fluid buildup in the body, particularly in the lower extremities. Jugular venous distention is another indicator of heart failure as it suggests increased central venous pressure and right-sided heart strain.

Peripheral artery disease (PAD) could cause pain in the legs, but it is usually associated with intermittent claudication, which resolves with rest. PAD is less likely to present with jugular venous distention and edema. An acute arterial occlusion could cause severe, sudden leg pain, but it would not explain the jugular venous distention. An aortic aneurysm could be painless or cause pain if ruptured; however, it would not typically present with bilateral leg edema or jugular venous distention unless it involved the heart.