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:

The nurse should compare the client's blood pressure readings with the expected outcomes to evaluate the effectiveness of the plan of care. This is the first step in the evaluation process, according to the nursing process framework. Comparing the actual outcomes with the expected outcomes allows the nurse to determine if the plan of care was successful or if it needs to be modified.

Choice B reason:

The nurse should identify the factors that influenced the client's blood pressure control, such as medication adherence, lifestyle changes, stress levels, and comorbidities. This is an important step in the evaluation process, but it is not the first one. The nurse should first compare the outcomes before analyzing the factors that affected them.

Choice C reason:

The nurse should document the results of the evaluation in the client's chart to communicate the findings to other members of the health care team and to provide evidence of quality care. This is also an essential step in the evaluation process, but it is not the first one. The nurse should document after comparing and analyzing the outcomes.

Choice D reason:

The nurse should modify the plan of care based on the evaluation findings to improve the client's blood pressure control and prevent complications. This is the final step in the evaluation process, after comparing, analyzing, and documenting the outcomes. The nurse should revise the plan of care as needed to meet the client's changing needs and goals.