Which finding would the nurse expect when assessing a patient with diastolic heart failure?
A) Lack of peripheral edema
B) Dyspnea at rest
C) Normal ejection fraction
D) Increased urinary output
C) Normal ejection fraction
Explanation: A) The kidneys are particularly susceptible to the hemodynamic effects of diastolic heart failure, also known as heart failure with preserved ejection function (HFpEF), and fluid retention is very problematic.
B) Decreased cardiac output activates the renin-angiotensin-aldosterone system (RAAS), leading to fluid retention, pulmonary and hepatic congestion, and dyspnea. Because of the normal ejection fraction, patients with HFpEF typically experience dyspnea only with exercise, as cardiac output may not be sufficient during increased demand.
C) Diastolic heart failure is seen in patients with normal contractility but abnormal relaxation of the heart. This type of heart failure is called heart failure with preserved ejection fraction (HFpEF), as these patients have heart failure in the presence of a normal ejection fraction.
D) The kidneys are particularly susceptible to the hemodynamic effects of HFpEF, and fluid retention is very problematic. The exact mechanism may be due to decreased CO, the effects of RAAS activation, or pressure exerted on the kidneys by fluid overload itself. When fluid is retained, urinary output decreases.
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