A nurse is assessing a patient with heart failure. The patient complains of shortness of breath, and the nurse auscultates crackles in both lungs. The nurse understands that these symptoms are the result of:
a. decreased force of ventricular contraction.
b. increased force of ventricular contraction.
c. decreased ventricular filling.
d. increased ventricular filling.
ANS: A
In the failing heart Starling's law breaks down, and the force of contraction no longer increases in proportion to the amount of ventricular filling. The result is the backup of blood into the lungs and the symptoms of shortness of breath and crackles caused by fluid. Increased ventricular contraction would not result in a backup of blood into the lungs. Changes in ventricular filling are not the direct cause of this symptom.
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