Question

In a review of the client's health history, the client indicates that she uses more than two pillows to sleep at night, becomes out of breath walking short distances, and has constant swelling in her feet and ankles. What condition is MOST likely causing these symptoms?

1) Hypertension
2) Asthma
3) Heart failure
4) Diabetes

Answer 1

The client's symptoms of requiring multiple pillows for sleep, shortness of breath on exertion, and swelling of feet and ankles are indicative of heart failure. These symptoms suggest a compromised skeletal muscle pump due to obesity and lack of exercise, both of which can worsen heart failure conditions.

Step-by-step explanation:

The client using more than two pillows to sleep at night, becoming out of breath walking short distances, and having constant swelling in her feet and ankles is most likely experiencing symptoms of heart failure. These signs, specifically orthopnea (the need to use multiple pillows to sleep), dyspnea on exertion (shortness of breath with minimal activity), and peripheral edema (swelling in feet and ankles), are classic presentations of heart failure. The skeletal muscle pump, which normally assists the return of blood from the lower extremities to the heart, might be compromised in this patient due to obesity and lack of physical activity, contributing to edema and worsening heart failure symptoms.