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This Concept Map, created with IHMC CmapTools, has information related to: Dr. C, Dr. C. has no allergies, Administer Lasix as ordered 1st intervention Excess fluid volume related to CHF as evidenced by SOB on exertion, Patient's pulse ox reading 95-99% on RA during my shift; no oxygen required at this time outcome Monitor patient's pulse oximetry twice per shift and administer previously ordered oxygen PRN, 2Liter fluid restriction thus Congestive heart failure, Dr. C. is a 58 year old male, Assess patient's level of anxiety and encourage verbalization of concerns 1st intervention Moderate anxiety related to percieved threat to self-concept as evidenced by Dr.'s focus on self and irritability, RR 14 . Vitals, Monitor patient's pulse oximetry twice per shift and administer previously ordered oxygen PRN 3rd intervention Excess fluid volume related to CHF as evidenced by SOB on exertion, Patient percieves level of stress as more manageable outcome Assess patient's level of anxiety and encourage verbalization of concerns, Use cognitive therapies to focus on faulty interpretations of his illness 3rd intervention Moderate anxiety related to percieved threat to self-concept as evidenced by Dr.'s focus on self and irritability, Patient reports decrease in dyspneic episodes during this shift outcome Review danger signs with patient that require immediate notification, Decreased cardiac output related to CHF as evidenced by dyspnea on exertion is Nursing Diagnosis # 3, Identify causative/ contributory factors that increase cardiac workload 3rd intervention Decreased cardiac output related to CHF as evidenced by dyspnea on exertion, Dr. C. is up ad lib, Moderate anxiety related to percieved threat to self-concept as evidenced by Dr.'s focus on self and irritability is Nursing Diagnosis #1, Patient appears more relaxed and reports anxiety as reduced to a manageable level outcome Use cognitive therapies to focus on faulty interpretations of his illness, HR 92 . Vitals, is on Room Air but 2L NC prn, Patient verbalizes understanding of plan and agrees to comply outcome Reinforce the need to restrict daily fluid intake to 2L, Reinforce the need to restrict daily fluid intake to 2L 2nd intervention Excess fluid volume related to CHF as evidenced by SOB on exertion