Question

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

a. Displacement of the apical impulse to the left
b. S3 heart sound
c. Paroxysmal nocturnal dyspnea
d. Jugular venous distention
e. Oliguria during the day
f. Wheezes or crackles

Answer 1

Expected clinical manifestations in a patient with left-sided heart failure include displacement of the apical impulse to the left, an S3 heart sound, paroxysmal nocturnal dyspnea, and wheezes or crackles upon auscultation. The options (A), (B), (C) and (F) are correct.

Step-by-step explanation:

During the assessment of a patient with left-sided heart failure, certain clinical manifestations might be expected due to the backward effects of the failing left ventricle. Here are the findings that a nurse would typically expect:

• Displacement of the apical impulse to the left (a)
• An S3 heart sound, also known as a ventricular gallop, which occurs when the ventricle is failing and dilated (b)
• Paroxysmal nocturnal dyspnea, which is sudden severe shortness of breath at night that awakens the patient from sleep, often with a coughing spasm (c)
• Wheezes or crackles heard upon auscultation, which may indicate fluid accumulation in the alveoli related to pulmonary congestion (f)

Features such as jugular venous distention (d) are more commonly associated with right-sided heart failure and oliguria during the day (e) aren't specific to left-sided failure and can be seen with various cardiological and renal conditions. Therefore, options (A), (B), (C), and (F) are correct.