Final answer:
The finding that should receive the highest priority in a client with decreased cardiac output post-MI is (d) decreased blood pressure. It indicates a direct consequence of the decreased cardiac output and can lead to critical organ hypoperfusion, triggering compensatory mechanisms such as renin and aldosterone release.
Step-by-step explanation:
The question pertains to the assessment of a client with a decreased cardiac output after a myocardial infarction (MI). When prioritizing clinical findings, it's essential to identify signs that indicate a potential critical deterioration of the patient's condition. The most relevant findings in a patient with decreased cardiac output would include symptoms that relate directly to the body's compensatory mechanisms and the impact on vital organs.
Option (d) Decreased blood pressure should receive the highest priority. Decreased blood pressure is a direct indication of decreased cardiac output and leads to reduced perfusion of tissues, including critical organs. This can prompt the release of renin from the kidneys (not the liver) and subsequent aldosterone secretion, which leads to sodium and water reabsorption to increase blood volume and help improve blood pressure. Conversely, increased respiratory rate, while also significant, is a compensatory mechanism for maintaining oxygenation and may indicate the body's response to hypoperfusion but is not as direct an indicator of cardiac output as blood pressure.
Other signs such as cool extremities might be associated with peripheral vasoconstriction, a compensatory response to maintain core circulation. Increased urine output, while counterintuitive in the setting of decreased cardiac output, could be a response to diuretic therapy or intrinsic renal problems but is not typically a direct complication of low cardiac output post-MI.