In congestive heart failure, what is common regarding fluid status?

• A. Arterial blockage causing tissue death
• B. There is no edema
• C. There is no change in fluid status
• D. Fluid backs up in the lungs or body

Answer: (D)

In congestive heart failure the heart’s pumping ability is impaired, which causes blood to back up in the venous system. That elevated venous pressure signals the kidneys to retain sodium and water, leading to overall fluid overload. The result is fluid accumulating where it shouldn’t—most notably in the lungs (pulmonary edema) and in peripheral tissues (edema). So, fluid backing up in the lungs or the body is the typical fluid-status change you’d expect with CHF.

Why the other ideas don’t fit: arterial blockage causing tissue death is related to ischemia from restricted blood flow, not the generalized fluid overload seen in CHF. Saying there’s no edema contradicts common findings, since edema is a hallmark of fluid retention in heart failure. Saying there’s no change in fluid status also ignores the central issue in CHF, which is impaired pumping with resulting fluid buildup.