Question

The nurse is assessing a patient with right sided heart failure. Which assessment findings does the nurse expect to see in this patient? (Select all that apply.)

a. Dependent edema
b. Weight loss
c. Polyuria at night
d. Hypotension
e. Hepatomegaly
f. Angina

Answer 1

Expected findings in right-sided heart failure include dependent edema, polyuria at night, hypotension, and hepatomegaly. Weight loss and angina are not typically seen unless associated with other conditions or advanced stages.

Step-by-step explanation:

Patients with right-sided heart failure have a rise in the pressure in the vena cavae due to the heart's inability to effectively pump blood into the pulmonary circulation. As a result, the following assessment findings are typically observed:

• Dependent edema
• Polyuria at night (nocturia)
• Hypotension
• Hepatomegaly (enlargement of the liver)

These symptoms occur due to the backward accumulation of blood in the organs and tissues served by the venous system that the right side of the heart drains. For example, dependent edema is common because of the increased pressure in the systemic venous system leading to the extravasation of fluid into tissues, especially in gravity-dependent areas. Hepatomegaly occurs due to congestion of the liver, which is also a result of increased venous pressure. In contrast, weight loss is not generally associated with right-sided heart failure; it may suggest other underlying conditions or advanced heart failure with cardiac cachexia. Polyuria at night (nocturia) can be related to the recumbency at night, which facilitates the return of fluid from the edematous areas to the central circulation, resulting in increased urine production. Angina (chest pain) is not a typical symptom of right-sided heart failure unless there is coexisting left-sided failure or coronary artery disease.