# The patient's jugular veins show pronounced ______ waves, a sign of right-sided heart failure.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=168396  
> language: ko  
> subject: Diseases of the circulatory system

## 문제

The patient's jugular veins show pronounced ______ waves, a sign of right-sided heart failure.

## 보기

1. distention **✔ 정답**
2. pulsation
3. collapse
4. retrograde
5. pressure

**정답: 1**

## 해설

Jugular vein distention (JVD) is a key finding in right-sided heart failure. The distention occurs because the failing right ventricle cannot effectively pump blood forward, leading to backup of blood in the venous system and visible neck vein distention.

## 임상 시나리오

Key Points:
- Jugular venous distention (JVD) assessment
- Normal jugular venous pressure: 6-8 cm H2O
- JVD > 3 cm above sternal angle indicates abnormal elevation
- Common causes of elevated JVD:
* Right heart failure
* Tricuspid regurgitation
* Constrictive pericarditis
* Superior vena cava obstruction
- Clinical examination:
* Patient position: 45-degree angle
* Observe internal jugular vein
* Measure vertical height above sternal angle
- Associated symptoms:
* Peripheral edema
* Hepatomegaly
* Ascites
* Dyspnea
- Kussmaul's sign: paradoxical rise in JVP during inspiration
- Lewis method for JVP measurement
- Hepatojugular reflux test
- Cannon a-waves in complete heart block

## 핵심 개념

- **distention** — The state of being enlarged, expanded, or swollen beyond normal size due to pressure from within
- **pulsation** — A rhythmic throbbing or vibrating movement, typically caused by the regular beating of the heart
- **collapse** — A sudden falling or giving way; a breakdown or failure of a structure or system
- **retrograde** — Moving backward or in a direction opposite to the normal direction
- **pressure** — The continuous physical force exerted on or against an object by something in contact with it

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