A patient with a diagnosis of pulmonary hypertension is admitted for evaluation of right ventricular heart failure. Which of the following observations by the nurse would indicate an improvement in his or her condition?
1. decreased peripheral edema
2. decreased rales and rhonchi in the lungs
3. development of an S3
4. increased central venous pressure
1
Rationale: Pulmonary hypertension will prevent right ventricular emptying resulting in fluid backup into the venous system leading to peripheral edema. Rales and rhonchi are an indication of left-sided heart failure. An S3 usually develops as the result of left ventricular failure with volume overload. Central venous pressure should decrease as the patient's condition improves.
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