The nurse is caring for a client with decreased cardiac output. Which of the following nursing actions should the nurse implement to monitor this client?
• Cardiac rhythm strips should be documented at least every 8 hours, and dysrhythmias reported for adequate cardiac management
• Common dysrhythmias include premature atrial contractions (PACs), premature ventricular contractions (PVCs), and paroxysmal atrial tachycardia (PAT). Changes in the ST segment may indicate myocardial ischemia from decreased coronary artery perfusion
• VS should be taken hourly, and tachycardia reported. Tachycardia can increase myocardial and oxygen demands and may be a compensatory mechanism related to the decreased cardiac output (increased heart rate to compensate for decrease in stroke volume). Assessment for this can help in prompt intervention
• Decreased strength of peripheral pulses is often found in clients with decreased cardiac output, and a further decrease in pulses from baseline may indicate further cardiac failure. Pulsus alternans indicates severe heart failure
• Oral care can help with the sensation of thirst without an increase in fluid intake. This promotes oral health maintenance but not cardiac pump effectiveness
• Diuretics are commonly prescribed to promote the diuresis of accumulated fluid in those with fluid volume overload
• Decreased systemic blood pressure can lead to stimulation of aldosterone, which leads to renal retention of sodium. A low-sodium diet is often prescribed to minimize water retention. This will not promote cardiac pump effectiveness