A young, male child is born with severe respiratory failure. Over the course of months, the parents note his body looks swollen. They ask, "Is our baby's kidneys not working right? Why is he so swollen?"

Question

The nurse bases his or her reply on which of the following physiological principles?
A) "The right side of his heart (cor pulmonale) is not pumping effectively. Blood is backlogging in his body, which is why he is so swollen."
B) "We just need to call the physician and ask him to give you a prescription for more water pills."
C) "Once we get his oxygenation level back to normal, then maybe his kidneys will receive enough oxygenated blood to filter better."
D) "This happens when he has so many secretions in his lungs. Maybe we should try some expectorant to thin his secretions so he can cough them out."

Answer 1

Ans: A
Feedback:
The term cor pulmonale refers to right heart failure resulting from primary lung disease or pulmonary hypertension. The increased pressures and work result in hypertrophy and eventual failure of the right ventricle. The manifestations of cor pulmonale include signs of right-sided heart failure, which include venous congestion, peripheral edema, shortness of breath, and a productive cough, which becomes worse during periods of heart failure. None of the other statements are applicable to these parents' questions.