Question

The nurse is caring for a client with primary pulmonary hypertension ( \(\mathrm{PPH})\). Which finding indicates a severe complication of PPH? A. Expectoration of frothy, pink-tinged sputum B. Decreased daytime voiding C. Edema of the legs and sacrum D. Hacking cough which worsens at night

Short answer

A) Expectoration of frothy, pink-tinged sputum B) Decreased daytime voiding C) Edema of the legs and sacrum D) Hacking cough which worsens at night Answer: A) Expectoration of frothy, pink-tinged sputum

Step-by-step solution

Understand Primary Pulmonary Hypertension (PPH)

Primary pulmonary hypertension (PPH) is a rare lung disorder characterized by increased blood pressure in the pulmonary arteries, which carry blood from the heart to the lungs. The increased pressure makes it difficult for the heart to pump blood through the lungs, leading to various complications.

Analyze Option A

Expectoration of frothy, pink-tinged sputum: This finding suggests the presence of blood in the sputum, which can be a sign of pulmonary edema, a severe complication where fluid accumulates in the lungs, leading to impaired gas exchange and shortness of breath. Pulmonary edema can be a consequence of PPH due to the increased pressure in the pulmonary vasculature and the resulting strain on the heart.

Analyze Option B

Decreased daytime voiding: This option does not seem to be related to a severe complication of PPH directly. It could be a symptom of various conditions, but it is not specific to PPH or its complications.

Analyze Option C

Edema of the legs and sacrum: While edema of the legs and sacrum can be a result of PPH, it is generally seen in patients with right-sided heart failure (which can be a consequence of PPH). However, this finding is not specific to a severe complication of PPH, as it can occur in multiple other conditions as well.

Analyze Option D

Hacking cough which worsens at night: A hacking cough that worsens at night could be indicative of multiple respiratory issues, but it is not specific to PPH or its complications. It doesn't indicate a severe complication of PPH.

Determine the correct answer

Based on our analysis, Option A (Expectoration of frothy, pink-tinged sputum) is the finding that indicates a severe complication of primary pulmonary hypertension (PPH), which is pulmonary edema. Thus, the correct answer is A.

Key concepts

Pulmonary Edema

Pulmonary edema is a critical condition that is characterized by an accumulation of fluid in the lung's air sacs, making it difficult for the lungs to perform their primary function of gas exchange. When related to primary pulmonary hypertension (PPH), pulmonary edema may result from the increased blood pressure in the pulmonary arteries. This additional strain can lead to fluid leakage from the blood vessels into the lung tissue.

PPH Symptom Analysis

Understanding the symptoms associated with PPH is crucial in managing the condition and identifying potential complications. Symptoms can range from fatigue and shortness of breath to more severe manifestations such as chest pain and the expectoration of frothy, pink-tinged sputum. The latter is particularly indicative of pulmonary edema, which is considered a severe complication of PPH and requires prompt medical attention.

Nursing Care for PPH

Nurses play a vital role in caring for patients with PPH. Nursing care involves monitoring vital signs, assessing the patient's respiratory status, and providing oxygen therapy as needed. Nurses must be alert for signs of complications, such as pulmonary edema, and should promptly report changes in the patient's condition. Managing fluid balance, providing emotional support, and educating patients about PPH are also essential components of nursing care.