The nurse should recognize which finding as a sign of decreased ...

[jazziefee]

The nurse should recognize which finding as a sign of decreased cardiac output and tissue perfusion in a patient with heart failure?
 
  1. reduced mental alertness
  2. increased urine output
  3. abdominal distention
  4. strong peripheral pulses

Question 2

An older patient was recently discharged to home after treatment for chronic heart failure. The patient experiences an increase in pulse rate from 80 beats per minute (bpm) to 102 bpm when walking from the kitchen to the utility room to do laundry.
 
  What should the home care nurse encourage the patient to do?
 
  1. complete tasks such as laundry early in the morning before fatigue is an issue
  2. ignore the pulse rate and become more active to build stamina
  3. rest for 30 minutes between loads of laundry
  4. rest on a chair in the utility room, and sit and rest when the patient feels the pulse rate increase

[macagnavarro]

Answer to Question 1

Correct Answer: 1
A change in mentation is a common sign of decreased cardiac output and tissue perfusion. Urine output would decrease and pulses would weaken. Abdominal distention is a sign of right-sided failure, which is a problem with venous return, not cardiac output or tissue perfusion.

Answer to Question 2

Correct Answer: 4
The increase in pulse rate indicates that activity is not being tolerated. Rest should help to bring the heart rate down to the pre-exercise level. Completing household tasks in the morning, ignoring the pulse rate and becoming more active, and resting 30 minutes between loads of laundry are not practical strategies for an older patient with compromised heart function. All home activities should be performed at a pace that is comfortable for the patient.