Question

A client in an ambulatory clinic describes awaking in the middle of the night with difficulty breathing and shortness of breath related to paroxysmal nocturnal dyspnea. Which underlying condition should the registered nurse (RN) identify in the client's history?

Chronic bronchitis.
Gastroesophageal reflux disease (GERD).
Heart failure (HF).
Chronic pancreatitis.

Answer 1

The registered nurse should identify Heart Failure (HF) as the potential underlying condition for paroxysmal nocturnal dyspnea, a symptom where a person wakes up from sleep with difficulty breathing and shortness of breath.

Step-by-step explanation:

A client in an ambulatory clinic describes waking in the middle of the night with difficulty breathing and shortness of breath related to paroxysmal nocturnal dyspnea (PND). The registered nurse (RN) should identify Heart Failure (HF) in the client's history as a potential underlying condition for PND. PND is a classic symptom of left-sided heart failure, where fluid backs up into the lungs leading to respiratory distress, particularly when the person is lying down. This symptom often prompts the individual to sit up or stand to relieve the difficulty in breathing. It is a serious condition requiring prompt medical evaluation and treatment. Other conditions such as chronic bronchitis, gastroesophageal reflux disease (GERD), and chronic pancreatitis also have associated respiratory symptoms but are less likely to directly cause PND.