A client diagnosed with left-sided heart failure has decreased cardiac output related to altered contractility. Which of the following nursing actions are appropriate for improving cardiac pump effectiveness?

Closely monitor fluid intake and output.
Monitor for dyspnea at rest.
Monitor orthostatic pressure and weight daily.
Provide a restful environment.

Explanation

• Providing a restful environment decreases the cardiac workload and oxygen demand.

• In clients with decreased cardiac output, increased fluid volume is not well tolerated by poorly functioning ventricles.

• Monitoring orthostatic hypotension and daily weights assesses for fluid status.

• Monitoring for dyspnea at rest assesses the degree of symptoms and signs or worsening condition.

• The client should be placed in semi- or High-Fowler's position with legs down to decrease the work of breathing and to decrease venous return and preload.

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