Questions: The backward effect of total heart failure may cause Select all that apply. jugular vein distension hypertension paroxysmal nocturnal dyspnea pulmonary edema pulmonary crackles

The backward effect of total heart failure refers to the consequences of the heart's inability to effectively pump blood, leading to congestion in the venous system. This can result in several symptoms and signs due to the accumulation of blood in various parts of the body. Let's evaluate each option:

1. Jugular vein distension: This is a correct option. In heart failure, especially right-sided heart failure, blood backs up into the venous system, leading to increased pressure in the jugular veins, causing them to become distended.

2. Hypertension: This is not typically a backward effect of heart failure. Hypertension is more often a contributing factor to heart failure rather than a result of it. Heart failure can lead to hypotension due to reduced cardiac output.

3. Paroxysmal nocturnal dyspnea: This is a correct option. It is a symptom of left-sided heart failure where fluid backs up into the lungs, causing difficulty breathing, especially at night.

4. Pulmonary edema: This is a correct option. It occurs when fluid accumulates in the lungs due to left-sided heart failure, as the heart is unable to effectively pump blood out, causing it to back up into the pulmonary circulation.

5. Pulmonary crackles: This is a correct option. Pulmonary crackles are heard on auscultation of the lungs and are indicative of fluid in the alveoli, which is a result of pulmonary edema from left-sided heart failure.

In summary, the backward effect of total heart failure may cause jugular vein distension, paroxysmal nocturnal dyspnea, pulmonary edema, and pulmonary crackles. Hypertension is not typically a backward effect of heart failure.