The nurse is educating a patient diagnosed with heart failure (HF). The nurse knows that instruction regarding compensatory mechanisms has been effective when the patient states,
1. "My heart enlarged in order to compensate for the effects of heart failure."
2. "My nervous system kicks in to compensate for the effects of heart failure."
3. "My body will decrease blood flow to other organs in order to compensate for heart failure."
4. "My body will increase urine output in order to compensate for the effects of heart failure."
5. "My body will produce anti-inflammatory agents to compensate for heart failure."
1,2,3
Rationale 1: Ventricular hypertrophy occurs as a compensatory mechanism to heart failure.
Rationale 2: One of the fastest homeostatic responses to diminished cardiac output is activation of the sympathetic nervous system (SNS). The increased heart rate resulting from sympathetic activation is a normal compensatory mechanism that serves to increase cardiac output.
Rationale 3: When cardiac output in a patient with HF is diminished, blood flow to the kidneys is reduced.
Rationale 4: Vasopressin (antidiuretic hormone), which is elevated in HF patients, causes fluid retention and worsens this condition.
Rationale 5: Two pro-inflammatory substances, tumor necrosis factor (TNF) and interleukin, are found in high levels in patients with HF and are associated with a poor prognosis.
Global Rationale: Ventricular hypertrophy occurs as a compensatory mechanism to heart failure. One of the fastest homeostatic responses to diminished cardiac output is activation of the sympathetic nervous system (SNS). The increased heart rate resulting from sympathetic activation is a normal compensatory mechanism that serves to increase cardiac output. When cardiac output in a patient with HF is diminished, blood flow to the kidneys is reduced. Vasopressin (antidiuretic hormone), which is elevated in HF patients, causes fluid retention and worsens this condition. Two pro-inflammatory substances, tumor necrosis factor (TNF) and interleukin, are found in high levels in patients with HF and are associated with a poor prognosis.
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