Question

A client diagnosed with heart failure presents with a temperature of 99.1° f, pulse 100 beats/minute, respirations 42 breaths/minute, bp 110/50 mm hg; crackles in both lung bases; nausea; and pulse oximeter reading of 89%. which finding indicates a need for immediate attention?

Answer 1

Since this is a known case of congestive heart failure, the general finding of lung congestion indicates a need for immediate attention. Also, the patient has deranged vital signs and needs attention. The blood pressure of the patient, particularly the diastolic blood pressure, is dropping (since the normal diastolic blood pressure is 60) and the patient may be in the early stages of shock. In the event of heart failure, most commonly in left sided heart failure, there is passive congestion of the lungs caused by pooling of the blood in the pulmonary circulation because of failure of the left ventricle to contract adequately. This will present as an increased respiratory rate and a low oxygen saturation as well as crackles indicating transudation; and this will be addressed as the patient's heart failure is managed. 

Answer 2

The medical finding of the patient diagnosed with the heart failure demanding the attention of the doctor is the crackles in the both lung bases. This is a sign of the lung congestion. The patient is suffering from the congestive heart failure. The congested lungs are mostly a result of the accumulation of the blood back into the veins taking blood through a person's lungs because the heart is unable to pump it efficiently to the body. The increased pressure in these veins makes the fluid to flow in the alveloi leading to low levels of oxygen making it difficult for the person to breathe.

Hence, the answer is 'lung congestion'.