The nurse is writing a plan of care for a client with a cardiac dysrhythmia. What would be the priority goal for the client?

A. Maintain adequate cardiac output: Adequate cardiac output ensures that oxygen and nutrients are delivered to vital organs and tissues, which is essential for survival. Cardiac dysrhythmias can compromise cardiac output, leading to hypotension, organ dysfunction, or shock. Prioritizing interventions to maintain perfusion addresses the most immediate risk.

B. Maintain normal cardiac structure: While preserving cardiac structure is important for long-term cardiac health, it is not the immediate priority in managing a dysrhythmia. Structural issues are chronic concerns, whereas maintaining perfusion through adequate cardiac output is an urgent, life-sustaining goal.

C. Maintain adequate control of chest pain: Controlling chest pain is important for client comfort and can prevent further myocardial stress, but it does not directly ensure tissue perfusion or prevent hemodynamic compromise. Pain management is supportive rather than the primary goal in dysrhythmia care.

D. Maintain a resting heart rate below 70 bpm: Targeting a specific heart rate is not the priority unless the heart rate is causing compromised cardiac output or symptoms. Focusing on a numerical goal without assessing perfusion may not adequately address the client’s immediate physiologic needs.

A. Increases the cardiac workload: Shivering significantly increases metabolic demand and oxygen consumption, which in turn raises heart rate and blood pressure. After coronary artery bypass graft surgery, the heart is vulnerable, and increased workload can precipitate ischemia or other cardiac complications, making slow rewarming essential.

B. Increases the amount of oxygen available to the heart: Shivering does not increase oxygen availability; in fact, it increases oxygen consumption by skeletal muscles, which can reduce the oxygen supply available to the myocardium.

C. Is uncomfortable to the client: While shivering is uncomfortable, the primary concern post-CABG is the physiological stress it places on the heart, not just discomfort.

D. Promotes diuresis and volume depletion: Shivering does not directly cause significant diuresis or volume depletion. The main risk is increased myocardial oxygen demand rather than fluid loss.