Question

The nurse is caring for a patient with heart failure. On assessment, the nurse notes that the patient is dyspneic, and crackles are audible on auscultation. What additional manifestations would the nurse expect to not in the patient if excess fluid volume is present?

Weight loss and dry skin
Flat neck and hand veins and decreased urinary output
An increase in blood pressure and increased respirations
Weakness and decreased central venous pressure

Answer 1

Additional manifestations in a patient with heart failure and excess fluid volume include an increase in blood pressure and increased respirations. Symptoms like swollen extremities and signs of uremia may also be present. Contrary indications such as weight loss, dry skin, and decreased central venous pressure are not expected in hypervolemia.

Step-by-step explanation:

If a patient with heart failure is experiencing excess fluid volume, a nurse would expect additional manifestations such as an increase in blood pressure and increased respirations. Excess fluid volume, also known as hypervolemia, can lead to pulmonary edema, where fluids accumulate in the lungs due to increased hydrostatic pressure in the pulmonary capillaries. This fluid overload can also result in hypertension, and as the condition progresses, other symptoms may include swollen extremities, a higher heart rate, and potential signs of uremia like uremic frost from crystallized urea on the skin. Weight loss and dry skin are generally not associated with excess fluid volume, while flat neck and hand veins typically indicate dehydration, a state opposite to hypervolemia.

Furthermore, decreased urinary output can be a result of the body's attempt to conserve fluid in cases of volume depletion, not excess. Weakness may be observed but decreased central venous pressure is unlikely since hypervolemia tends to elevate central venous pressure due to the extra volume in the vascular system.