The nurse is planning care for an elderly patient diagnosed with end-stage heart failure and a nursing diagnosis of Decreased Cardiac Output secondary to ineffective left ventricular function
What outcome would the nurse plan for this patient to measure improvement in cardiac output?
a. Brisk capillary refill in feet bilaterally.
b. Heart rate within expected range
c. Breath sounds clear with no shortness of breath
d. Regular pulse rhythm
C
Left-sided failure causes blood to back up into the lungs and can result in pulmonary edema; therefore, clear breath sounds with no shortness of breath would be an effective outcome. When the right ventricle is compromised by heart failure, venous return is slowed and peripheral edema results; however, this patient has left-sided failure. Medications to treat heart failure are meant to alter heart rate, so this would not be the best indicator of improvement in the patient's condition. A patient with heart failure may have a regular rhythm even before treatment, so this is not the best choice for an indication of improved cardiac output.
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