A client with heart failure has orthopnea, tachycardia, fatigue, and activity intolerance. The nurse instructs the client that these symptoms are a result of the client's:
1. Inherent compensatory mechanisms trying to maintain a good blood pressure and oxygenation.
2. Inability to cope with the body's changing health.
3. Inability to follow instructions.
4. Inherent compensatory mechanisms that are malfunctioning.
Inherent compensatory mechanisms trying to maintain a good blood pressure and oxygenation.
Rationale: The client's compensatory mechanisms attempt initially to compensate for the failing blood pressure and oxygen levels. At the outset, these mechanisms are able to keep up with the body's demands. However, long term, they create bigger problems. The client's symptoms are not a result of the client's inability to cope with the body's changing health or to follow instructions, since the client has no power over the compensatory mechanisms. The client's inherent compensatory mechanisms are not malfunctioning, but instead continue to attempt to maintain homeostasis.
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