The nurse is caring for a client diagnosed with dilated cardiomyopathy. Which clinical manifestations does the nurse anticipate during the physical assessment? Select all that apply.

Correct Answer: A

Rationale: In dilated cardiomyopathy, the heart muscle becomes weakened and enlarged, leading to decreased cardiac output. Fatigue is a common manifestation due to the heart's inability to pump effectively. This results in reduced oxygen delivery to tissues, causing fatigue. Lower extremity edema can occur in conditions where the heart is unable to adequately pump blood, leading to fluid buildup in the extremities. Syncope is not typically associated with dilated cardiomyopathy unless severe arrhythmias are present. Dyspnea is commonly seen in heart failure but may not be specific to dilated cardiomyopathy. Educationally, understanding the pathophysiology of dilated cardiomyopathy helps in differentiating its clinical manifestations from other cardiac conditions. Nurses should be able to recognize these manifestations to provide appropriate care and interventions for clients with dilated cardiomyopathy. This knowledge enhances their assessment skills and aids in developing individualized care plans to improve patient outcomes.

Correct Answer: A

Rationale: For a client with coronary artery disease, physical rest is important to help decrease cardiac workload and sympathetic nervous system stimulation. Physical rest helps reduce the demand on the heart muscle, allowing the heart to work more efficiently. By minimizing physical activity, the client can prevent further strain on the heart and lower the risk of complications such as angina or heart attack. Additionally, reducing physical activity can help lower blood pressure and heart rate, which in turn decreases the workload on the heart. Thus, recommending physical rest is essential in managing and improving outcomes for clients with coronary artery disease.

Correct Answer: C

Rationale: Disseminated intravascular coagulation (DIC) is a serious condition characterized by widespread clot formation in the small blood vessels, leading to bleeding tendencies. In DIC, the body consumes clotting factors and platelets faster than they can be replaced, resulting in both bleeding and clotting. Because of this complex pathophysiology, the first line treatment for DIC-related bleeding is to provide replacement of the consumed clotting factors and platelets. Fresh frozen plasma contains clotting factors, and platelets help in stopping bleeding by aiding in clot formation. Therefore, the administration of fresh frozen plasma and platelets helps to correct the coagulopathy in DIC and manage the bleeding episodes effectively. Aspirin, Warfarin (Coumadin), and Heparin are anticoagulants and would not be appropriate in the treatment of DIC-related bleeding as they can exacerbate the bleeding tendency in this condition.

Correct Answer: B

Rationale: This client statement indicates that they understand the importance of making lifestyle modifications to manage hypertension. Giving up cigarettes and alcohol can significantly improve blood pressure control and overall health for someone with hypertension. It demonstrates that the client is willing to make necessary changes to help manage their condition effectively.

Correct Answer: D

Rationale: In a client with preeclampsia, one of the laboratory values that the nurse might anticipate is an increased serum creatinine level. Preeclampsia is a hypertensive disorder of pregnancy characterized by high blood pressure and involvement of multiple organ systems, including the kidneys. An elevated serum creatinine level indicates impaired kidney function, as creatinine is a waste product that is normally filtered by the kidneys and excreted in the urine. In preeclampsia, reduced kidney perfusion due to the high blood pressure can lead to decreased glomerular filtration rate, resulting in elevated serum creatinine levels. Monitoring serum creatinine is essential in assessing kidney function and guiding management in clients with preeclampsia.