Which of the following symptoms might a client with right-sided heart failure exhibit?
A. Adequate urine output
B. Polyuria
C. Oliguria
D. Polydipsia
Correct Answer: C. Oliguria
Inadequate deactivation of aldosterone by the liver after right-sided heart failure leads to fluid retention, which causes oliguria. Oliguria is a late finding in heart failure, and it is found in patients with markedly reduced cardiac output from severely reduced LV function. Nocturia may occur relatively early in the course of heart failure. Recumbency reduces the deficit in cardiac output in relation to oxygen demand, renal vasoconstriction diminishes, and urine formation increases.
Option A: When the body thinks it needs more fluid in its blood vessels, it releases specific chemicals (renin, angiotensin, and aldosterone) that cause the blood vessels to constrict. In addition, these hormones cause the body to retain more sodium and water. This adds fluid to the circulatory system. This fluid becomes part of the blood circulating throughout the system.
Option B: With heart failure, the heart doesn’t pump as well as it should. So the body doesn’t get enough blood and oxygen. When this occurs, the body believes that there isn’t enough fluid inside its vessels. The body’s hormone and nervous systems try to make up for this by increasing blood pressure, holding on to salt (sodium) and water in the body, and increasing heart rate. These responses are the body’s attempt to compensate for the poor blood circulation and backup of blood.
Option D: Primary polydipsia (PP) is a condition where there is excess consumption of fluids leading to polyuria with diluted urine and, ultimately, hyponatremia. Polyuria can be defined as urine production greater than 40-50 ml/kg in a twenty-four-hour period.
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