A female client is admitted to the emergency department with complaints of chest pain and shortness of breath. The nurse’s assessment reveals jugular vein distention. The nurse knows that when a client has jugular vein distension, it’s typically due to:
A. A neck tumor
B. An electrolyte imbalance
C. Dehydration
D. Fluid overload
Correct Answer: D. Fluid overload
Fluid overload causes the volume of blood within the vascular system to increase. This increase causes the vein to distend, which can be seen most obviously in the neck veins. JVD is a sign of increased central venous pressure (CVP). That’s a measurement of the pressure inside the vena cava. CVP indicates how much blood is flowing back into the heart and how well the heart can move that blood into the lungs and the rest of the body.
Option A: A neck tumor doesn’t typically cause jugular vein distention. Right-sided heart failure is a common cause. Right-sided heart failure usually develops after a left-sided heart failure. The left ventricle pumps blood out through the aorta to most of the body. The right ventricle pumps blood to the lungs. When the left ventricle’s pumping power weakens, fluid can back up into the lungs. This eventually weakens the right ventricle.
Option B: An electrolyte imbalance may result in fluid overload, but it doesn’t directly contribute to jugular vein distention. The pericardium is a thin, fluid-filled sac that surrounds the heart. An infection of the pericardium, called constrictive pericarditis, can restrict the volume of the heart. As a result, the chambers can’t fill with blood properly, so blood can back up into veins, including the jugular veins.
Option C: Dehydration does not cause JVD. Another common cause is pulmonary hypertension. Pulmonary hypertension occurs when the pressure in your lungs increases, sometimes as a result of changes to the lining of the artery walls. This can also lead to right-sided heart failure.