Question

The nurse is caring for a client with primary pulmonary hypertension who has developed cor pulmonale. Which finding is characteristic of the client with cor pulmonale? A. Expectoration of frothy, pink sputum B. Decreased daytime voiding C. Edema of the legs and sacrum D. Hacking nighttime cough

Short answer

Answer: Edema of the legs and sacrum.

Step-by-step solution

Understand cor pulmonale

Cor pulmonale is a medical condition in which the right side of the heart becomes enlarged due to increased pressure in the pulmonary arteries, usually caused by chronic lung diseases. This results in right-sided heart failure, which can lead to various symptoms and complications.

Analyze each option

A. Expectoration of frothy, pink sputum: This is a symptom of pulmonary edema, where fluid accumulates in the air sacs of the lungs, causing frothy, pink sputum. While pulmonary edema can be a complication of cor pulmonale, it is not the characteristic finding. B. Decreased daytime voiding: This is not specifically related to cor pulmonale. Decreased daytime voiding could be linked to various other causes like dehydration or urinary retention. C. Edema of the legs and sacrum: When the right side of the heart is unable to pump blood effectively, it can lead to a buildup of fluid in the body. This causes swelling in the legs and sacrum, which is a characteristic finding of cor pulmonale. D. Hacking nighttime cough: A nighttime cough can be a symptom of many different respiratory conditions, but it is not specific or characteristic of cor pulmonale.

Identify the correct answer

Based on the analysis of each option, the correct answer is: C. Edema of the legs and sacrum. This is the characteristic finding in clients suffering from cor pulmonale.

Key concepts

Cardiovascular Nursing

As part of cardiovascular nursing, understanding conditions like cor pulmonale becomes crucial in patient care. In essence, cor pulmonale is an enlargement of the right ventricle due to high blood pressure in the lungs caused by pulmonary disorders. Nurses should be adept at recognizing the signs associated with right-sided heart failure, which includes swelling or edema in the legs and sacrum, among other symptoms.

Nursing interventions focus on monitoring cardiovascular status, managing symptoms, administering prescribed medications, and providing education on lifestyle modifications to prevent worsening of the condition. It is essential for nurses to assess for leg edema and difficulty in breathing, administer diuretics as ordered, and monitor oxygen therapy to ensure adequate tissue perfusion and oxygenation. Moreover, educating patients about the significance of adhering to a low-sodium diet and the importance of regular follow-up appointments cannot be overstated.

Pulmonary Hypertension

Pulmonary hypertension is a key contributor to the development of cor pulmonale. When discussing pulmonary hypertension, it's important to understand that it is a type of high blood pressure that affects the arteries in the lungs and the right side of the heart.

In the early stages, it may present with no symptoms or only mild symptoms, but as the condition progresses, symptoms such as shortness of breath during routine activities, tiredness, chest pain, and a racing heartbeat become more apparent. In relation to cor pulmonale, pulmonary hypertension leads to an increased workload on the right side of the heart, which can cause the heart muscle to weaken and eventually fail. Nurses should be observant for these symptoms and collaborate with healthcare teams to manage the care of patients with pulmonary hypertension effectively.

NCLEX-RN Exam Preparation

Preparing for the NCLEX-RN exam requires a comprehensive understanding of conditions like cor pulmonale and pulmonary hypertension. To effectively prepare, students should focus on mastering the pathophysiology, signs and symptoms, and the appropriate nursing interventions for these conditions.

Using practice questions and rationales similar to the ones found in the exercise can significantly enhance test-taking skills. It's not just about knowing the facts, but being able to apply them in a clinical scenario. For example, knowing that edema of the legs and sacrum is characteristic of cor pulmonale, and not confusing it with symptoms of other conditions, is essential for making the right decisions under exam conditions. Study resources, like comprehensive review books, online courses, and hands-on clinical experiences, also play a vital role in ensuring that the knowledge is both theoretical and practically applicable.