RN Nursing · Heart Failure · Practice question
What would be the assessment findings of Congestive Heart Failure? Select all that apply
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Elevated Jugular Venous Pressure
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Hepatojugular reflux
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Bibasilar crackles
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Cold extremities with narrow pulse pressure
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S3 gallop
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Edema in lower extremities
Answer & explanation
Correct: Elevated Jugular Venous Pressure · Hepatojugular reflux · Bibasilar crackles · Cold extremities with narrow pulse pressure · S3 gallop · Edema in lower extremities
Congestive heart failure (CHF) produces a characteristic constellation of findings that span both right-sided and left-sided failure. Elevated jugular venous pressure (JVP) reflects increased right atrial pressure from fluid overload and impaired right-sided cardiac function, and is a reliable sign of volume congestion. Hepatojugular reflux — sustained elevation of the JVP when pressure is applied to the right upper quadrant — confirms elevated central venous pressure and right heart failure. Bibasilar crackles result from fluid transudation into the pulmonary alveoli due to elevated pulmonary capillary wedge pressure from left ventricular failure; auscultation reveals fine inspiratory crackles at the lung bases. Cold extremities with a narrow pulse pressure arise from low cardiac output, peripheral vasoconstriction compensating for reduced stroke volume, and reduced tissue perfusion. An S3 gallop, heard in early diastole, is produced when blood rushes into a volume-overloaded, poorly compliant ventricle; it is a classic and highly specific sign of heart failure. Lower extremity edema is a direct consequence of elevated hydrostatic pressure in the venous circulation, reduced oncotic pressure, and sodium and water retention driven by neurohormonal activation. All six options represent genuine assessment findings of CHF, making every listed choice correct.
Study note
Heart Failure: A Nursing Overview
What heart failure is, how left-sided and right-sided failure differ, and the nursing priority that catches fluid overload earliest.
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