Unfolding clinical reasoning case study answers heart failure

In obvious resp distress that must be addressed but the UNDERLYING cause must be addressed in order to remedy this effectively. NEED TO IMMEDIATELY DECREASE THE WORKLOAD OF THE HEART by getting rid of excess fluid volume (reducing preload) What is the underlying rationale/patho of this concern?

To accomplish this clinical objective need to reduce the cardiac output determinant of preload (volume reduction through diuresis) and lower afterload (systolic BP) to decrease the resistance that the LV needs to overcome to pump each contraction to the body.

Rationale: HR 126-Pale cool to the touch…sympathetic nervous system stimulation to maintain cardiac output…remember CO=SVxHR 2-3+ pitting edema…fluid volume overload with left sided HF transferring over and causing biventricular failure (both right and left failure)

By lowering afterload and systolic BP you can immediately decrease the workload and stress of the heart. What medical or nursing interventions will you initiate based on this priority concern?