Question

A 70-year-old patient is being seen in the clinic for severe exacerbation of his heart failure. Which of the following findings is the nurse most likely to observe in this situation?

1.Shortness of breath, orthopnea, paroxysmal nocturnal dyspnea, ankle edema
2.Rasping cough, thick mucoid sputum, wheezing
3.Productive cough, dyspnea, weight loss, anorexia
4.Fever, dry nonproductive cough, bronchial breath sounds

Answer 1

A 70-year-old patient with a severe exacerbation of heart failure is most likely to exhibit signs of fluid retention such as shortness of breath, orthopnea, paroxysmal nocturnal dyspnea, and ankle edema.

Step-by-step explanation:

The most likely findings observed by a nurse in a 70-year-old patient with a severe exacerbation of heart failure would include clinical signs of fluid overload and impaired cardiac function such as shortness of breath, orthopnea (difficulty breathing when lying flat), paroxysmal nocturnal dyspnea (sudden shortness of breath at night), and ankle edema. These symptoms are indicative of left-sided heart failure, where the heart is unable to effectively pump blood forward, causing fluid to back up into the lungs and peripheral tissues.