The nurse is assessing a client for chronic rheumatic heart disease. What symptom would indicate that the client's condition is severe and requires immediate attention?
A) The client's systolic blood pressure falls below 90 mm Hg.
B) The client complains of shortness of breath with exercise.
C) The client complains of a dry cough.
D) The client exhibits a low-grade fever.
A
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When the condition of a client with chronic rheumatic heart disease worsens, the client's feet and ankles swell, the liver enlarges, and the abdominal cavity fills with fluid. Systolic blood pressure may fall below 90 mm Hg. Immediate attention is required because such signs indicate heart failure. Shortness of breath with exercise or dry cough is not a sign of the condition and does not require immediate attention. The client exhibits a low-grade fever that gradually increases in the case of subacute bacterial endocarditis; signs of congestive heart failure (CHF) appear as the disease progresses.
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