A patient is admitted to the hospital for an acute exacerbation of heart failure. The nurse questions the patient about his medical and social history. Which of the following would not contribute to this patient's exacerbation?

Irritable bowel syndrome

Explanation

• Irritable bowel syndrome is not known to cause CHF exacerbations

• Chronic congestive heart failure can easily exacerbate and decompensate. This commonly results from infections, arrhythmias, hypertension, anemia, hyperthyroidism, inadequate diet, and medications such as NSAIDs

This question asked to identify the condition that does not exacerbate CHF, so the following choices are incorrect:

• Incorrect: NSAIDs can cause fluid and sodium retention, increasing the workload of the heart and exacerbating heart failure

• Incorrect: Anemia and hyperthyroidism place additional strain on the heart leading to exacerbations as well

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