An elderly client diagnosed with cardiomyopathy reports having to ...

[nevelica]

An elderly client diagnosed with cardiomyopathy reports having to rest between activities during the day. The nurse realizes the reason for this client's fatigue would be:
 
  1. Decreased cardiac output.
   2. Increased blood pressure.
   3. An elongated and dilated aorta.
   4. Increased stroke volume.

Question 2

The nurse delegated an unlicensed assistive person (UAP) to assist a client with performing a simple dressing change. The client was formerly able to do the procedure, but because of painful arthritis is now unable to perform the redressing.
 
  The UAP has done this procedure before. Which of the following must the nurse emphasize to the UAP? 1. Make the client do most of the procedure and report the expected output.
   2. If there are any unusual observations during the procedure, such as bleeding or signs of infection, call the nurse immediately.
   3. The nurse should demonstrate the steps of the procedure.
   4. The UAP should do health teaching while performing the procedure.

[firehawk60]

Answer to Question 1

1. Decreased cardiac output.

Rationale:
Decreased cardiac output is a result of decreased efficiency and contractibility of the myocardium. Rest could be required after each activity that puts physiological stress on the heart. Less blood is pumped from the heart to the rest of the body with a decreased cardiac output, and this has a direct effect on the activity level that can be tolerated. It is unknown if the client has high blood pressure, an elongated and dilated aorta, or increased stroke volume.

Answer to Question 2

2. If there are any unusual observations during the procedure, such as bleeding or signs of infection, call the nurse immediately.

Rationale:
The nurse delegated a specific legal task to the UAP, which is within the scope of the UAP's ability. The nurse established the particular parameters outside of which immediate notification is requested. If in pain, the client should not have to do any of the procedure. If the UAP has done the procedure before, so the nurse should not need to demonstrate it. Health teaching is outside of the scope of practice for the UAP.