A nurse is assessing a client who has right ventricular failure. Which of the following findings should the nurse expect?

Choice A rationale A dry, hacking cough is a classic manifestation of left-sided heart failure (LVEF less than 40 percent) due to the backup of fluid from the left ventricle into the pulmonary circulation, causing pulmonary congestion and irritation of the bronchioles. This accumulation of fluid within the alveoli and interstitial spaces impairs gas exchange, leading to the characteristic cough, which is often worse when lying flat, a condition known as orthopnea. Choice B rationale Right ventricular failure (RVF) leads to systemic venous congestion because the failing right ventricle cannot effectively pump blood forward into the pulmonary artery, causing a back-up of blood into the systemic veins. This increased pressure is transmitted to the liver via the inferior vena cava, leading to hepatomegaly (liver enlargement) and potentially impaired liver function. Normal size is 15 cm. Choice C rationale Episodes of dizziness, or syncope, often indicate decreased cerebral perfusion due to reduced cardiac output, which is a primary feature of left-sided heart failure. In right-sided heart failure, the primary pathology involves the systemic venous system, causing peripheral and visceral congestion rather than immediately compromising the flow of blood out of the heart and to the brain. Choice D rationale Fluid in the lungs, known as pulmonary edema or congestion, is a hallmark sign of left-sided heart failure. The failure of the left ventricle causes blood to back up into the left atrium and subsequently into the pulmonary veins, increasing hydrostatic pressure and forcing fluid out of the capillaries into the lung tissue, impairing oxygenation. —.