Evolve Cardiovascular Practice Test

In a chronic heart failure exacerbation, a common symptom to expect is a severe cough. This cough typically arises due to pulmonary congestion that results from the heart's reduced ability to pump blood effectively. As fluid backs up into the lungs, it can lead to symptoms such as coughing, wheezing, and difficulty breathing, particularly when lying flat or during exertion.

The presence of a severe cough can also indicate that the squeezed heart is unable to manage the venous return, causing fluid to seep into the interstitial space of the lungs and triggering a cough reflex. Patients may often describe the cough as being particularly bothersome, especially at night, when lying down exacerbates the pulmonary congestion.

Other symptoms commonly associated with chronic heart failure may differ in nature. For example, decreased appetite can occur due to gastrointestinal congestion or medications like diuretics, increased urine output is usually associated with diuretic treatment, and severe headaches are not directly linked to heart failure exacerbation but could relate to other conditions or treatments. Thus, the cough is a hallmark symptom closely tied to the pulmonary implications of heart failure exacerbation, significantly aiding the nurse in identifying the patient's current status and urgent needs.