A nurse assesses a client with an irregular pulse. What client problem should the nurse include in the client's plan of care?

Choice A reason: Impaired nutrition is generally unrelated to the immediate assessment of an irregular heart rhythm. While chronic heart failure can lead to cardiac cachexia, an irregular pulse is a hemodynamic issue that affects the delivery of nutrients, not the intake of nutrition itself, making it a secondary concern. Choice B reason: While certain metabolic imbalances can cause arrhythmias, a risk for unstable blood glucose is a metabolic diagnosis. An irregular pulse is a direct cardiovascular finding. The primary concern with an arrhythmia is the heart's mechanical ability to pump blood, not the concentration of glucose in the bloodstream. Choice C reason: An irregular pulse, such as that found in atrial fibrillation or premature contractions, often leads to a decrease in stroke volume and overall cardiac output. This happens because the heart cannot fill properly or contract synchronously, potentially leading to inadequate tissue perfusion and organ dysfunction. Choice D reason: Altered body image is a psychosocial diagnosis related to how a person perceives their physical appearance. An irregular pulse is a physiological dysfunction of the cardiac conduction system. While the client may feel "palpitations," this does not inherently alter their perception of their physical body or self-image.