A nurse is performing a physical assessment on a patient with heart failure. If Starling's law were to break down, what is the most significant clinical manifestation the patient could display?
a. Increased heart rate
b. Decreased blood volume
c. Increased blood pressure
d. Shortness of breath
ANS: D
In a failing heart, Starling's law breaks down. The force of contraction no longer increases in proportion to increased ventricular filling. Blood backs up behind the failing ventricle, which causes blood to back up in the pulmonary circulation. This leads to respiratory symptoms, including dyspnea, or shortness of breath.
An increased heart rate would be expected because of the increase in volume; however, this would not be the most significant finding related to heart failure.
The patient would not have a decrease in blood volume.
An increase in blood pressure probably would be expected, but this would not be the most significant finding related to heart failure.
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