Failing Frank — Heart Failure
Left = lungs, right = rest of the body; weigh daily
Frank sleeps on three pillows and still wakes gasping at 2 a.m. His scale tells the story days before his lungs do.
Frank's ventricle cannot keep up. Left-sided failure backs into the lungs — crackles, orthopnea, frothy sputum. Right-sided backs into the body — JVD, edema, ascites, weight gain. Daily weights catch it earliest: 2–3 lb in a day means call.
Read Failing Frank's full story →The story arc
The setup
Years of hypertension and a previous MI stiffen and weaken his left ventricle.
The turn
He needs three pillows to sleep, wakes gasping at night, and his shoes stop fitting.
The crisis
Five pounds gained in three days, crackles to mid-lung, pink frothy sputum and SpO₂ 86%.
The save
High-Fowler's with legs dependent, oxygen, IV furosemide, then daily weights, sodium restriction and medication teaching at discharge.
NCLEX study section — Heart Failure
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Cardiovascular
Take this chapter into practice questions on the same topic.