Which sign should the nurse include when teaching about right-sided heart failure in COPD patients?

In the context of right-sided heart failure, particularly in patients with chronic obstructive pulmonary disease (COPD), peripheral edema is a significant sign to address. Right-sided heart failure, often referred to as right ventricular failure, leads to the heart's inability to effectively pump blood to the lungs and can cause a backlog of blood in the systemic circulation. This results in increased pressure in the veins, leading to fluid accumulation in the lower extremities, evidenced by peripheral edema.

Patients with COPD may develop pulmonary hypertension due to chronic hypoxia, which can place additional strain on the right heart, further contributing to the development of peripheral edema. When teaching patients about the signs and symptoms associated with right-sided heart failure, it is crucial to highlight the presence of swelling in the legs and ankles as a common and most observable indicator of this condition.

Other signs, while relevant in various contexts, do not primarily indicate right-sided heart failure in COPD patients. Clubbing of the nail beds may occur with chronic respiratory conditions but is more associated with persistent low oxygen levels over time. Hypertension is more commonly discussed in relation to left-sided heart failure and is not a direct sign of right-sided heart failure. Increased appetite is generally not characteristic of heart failure; in fact, many patients