Final answer:
The nurse should prioritize reporting an increased respiratory rate in a patient with right-sided heart failure, as it may indicate respiratory distress or hypoxemia, which is potentially life-threatening and requires immediate attention.
Step-by-step explanation:
The student is asking about the priority finding to report in an older adult who has right-sided heart failure. Among the options, the nurse should prioritize reporting an increased respiratory rate (c). This is because an increased respiratory rate may indicate that the patient is experiencing respiratory distress or hypoxemia, which can be a life-threatening condition requiring immediate attention. The other symptoms, such as swelling in the lower extremities (a), fatigue and weakness (b), and elevated blood pressure (d), are also concerning, but they are typical findings associated with right-sided heart failure and usually do not require emergency intervention as urgently as a significant increase in respiratory rate does.
An increased respiratory rate can result from the heart's inability to pump blood effectively, leading to fluid backlog and compromised gas exchange in the lungs. In right-sided heart failure, this can lead to systemic edema and increased fluid retention within the body, as the failure affects the flow of blood returning to the heart from systemic circulation. If the respiratory system is being compromised, it's most likely that the edema and fluid retention are having an immediate impact on lung function, thereby elevating the priority of this symptom.