A nurse is relating outcomes to interventions for a client with heart failure who was discharged from the hospital 2 weeks ago. Which of the following statements should the nurse make?

Choice A reason:

This statement is incorrect because it does not relate an outcome to an intervention. The client's weight loss may be due to increased diuretic therapy, but it is not clear how this is an outcome of the nurse's actions. A better statement would be: "The client's weight has decreased by 2 kg since discharge as a result of the nurse's education on diuretic therapy and daily weight monitoring.".

Choice B reason:

This statement is incorrect because it does not relate an outcome to an intervention. The client's dyspnea may be due to noncompliance with fluid restriction, but it is not clear how this is an outcome of the nurse's actions. A better statement would be: "The client's dyspnea has worsened despite the nurse's education on fluid restriction and sodium intake.".

Choice C reason:

This statement is incorrect because it does not relate an outcome to an intervention. The client's edema may have improved due to elevation of the lower extremities, but it is not clear how this is an outcome of the nurse's actions. A better statement would be: "The client's edema has improved as a result of the nurse's instruction on elevating the lower extremities and wearing compression stockings.".

Choice D reason:

This statement is correct because it relates an outcome to an intervention. The client's fatigue may have decreased due to participation in a cardiac rehabilitation program, which is an intervention that the nurse can facilitate or recommend for a client with heart failure. This statement shows that the nurse is evaluating the effectiveness of the intervention and the client's progress.

Choice A reason:

This choice is incorrect because the problem is not resolved by the client's self-report of feeling happier and more hopeful. The nurse should assess other indicators of improvement, such as mood, affect, cognition, behavior, and functioning. Feeling happier and more hopeful may be a sign of progress, but it does not mean that the problem is completely resolved.

Choice B reason:

This choice is incorrect because the problem is not ongoing if the client has been receiving psychotherapy and antidepressant medication for 6 weeks. The nurse should expect some degree of improvement in the client's symptoms and functioning after this period of treatment. Suicidal thoughts and low self-esteem are serious concerns, but they may not reflect the current problem status of the client.

Choice C reason:

This choice is correct because the problem is improved if the client shows increased interest in social activities and hobbies. These are positive signs of recovery from depression, as they indicate that the client is experiencing more pleasure, motivation, and engagement in life. The nurse should acknowledge and reinforce these improvements, as well as monitor the client's response to treatment.

Choice D reason:

This choice is incorrect because the problem is not potential if the client has already been diagnosed with depression and is receiving treatment. The client is at risk for relapse and adverse effects of medication, but these are not problems that need to be addressed at this stage. The nurse should focus on evaluating the effectiveness of the current treatment plan and providing education and support to the client