Final answer:
A client with systolic dysfunction and an ejection fraction of 38% is likely to experience a decrease in tissue perfusion due to a reduction in the volume of blood being pumped by the heart. Normal ejection fraction ranges between 55-70%, and a lower value indicates impaired heart contractility.
Step-by-step explanation:
A client with systolic dysfunction who has an ejection fraction of 38% typically experiences a reduction in the volume of blood ejected from the heart during each contraction. Since ejection fraction is the portion of blood pumped out of the heart with each beat, and normal values range between 55-70%, a value of 38% indicates a decrease in stroke volume. Consequently, this reduced stroke volume leads to a decrease in tissue perfusion, as there is less blood being circulated through the body's tissues.
Factors affecting stroke volume and cardiac output include sympathetic stimulation and levels of various substances like catecholamines and electrolytes. Positive factors increase heart contractility and stroke volume, while negative factors decrease them. Given that systolic dysfunction impairs the heart's ability to pump effectively, the associated physiological changes would not include an increase in stroke volume, an increase in oxygen saturation, or a decrease in arterial vasoconstriction.