You are caring for a 71-year-old patient who is 4 days postoperative for bilateral inguinal hernias. The patient has a history of congestive heart failure and peptic ulcer disease

Question

The patient is highly reluctant to ambulate and will not drink fluids except for hot tea with her meals. The nurse's aide reports to you that this patient's vital signs are slightly elevated and that she has a nonproductive cough. When you assess the patient, you auscultate crackles at the base of the lungs. What would you suspect is wrong with your patient?
A) Pulmonary embolism
B) Hypervolemia
C) Hypostatic pulmonary congestion
D) Malignant hyperthermia

Answer 1

Ans: C
Feedback:
Hypostatic pulmonary congestion, caused by a weakened cardiovascular system that permits stagnation of secretions at lung bases, may develop; this condition occurs most frequently in elderly patients who are not mobilized effectively. The symptoms are often vague, with perhaps a slight elevation of temperature, pulse, and respiratory rate, as well as a cough. Physical examination reveals dullness and crackles at the base of the lungs. If the condition progresses, then the outcome may be fatal. A pulmonary embolism does not have this presentation and hypervolemia is unlikely due to the patient's low fluid intake. Malignant hyperthermia occurs concurrent with the administration of anesthetic.