Use this nursing care plan guide to help you create nursing interventions for decreased cardiac output nursing diagnosis. Show The nursing diagnosis decreased cardiac output occurs if the blood pumped by the heart does not meet the metabolic demands of the body. Cardiovascular diseases such as myocardial infarction, heart failure, dysrhythmias, and other problems in fluid volume or effects of some drugs can cause a decrease in cardiac output. Cardiac output is the amount of blood pumped by the heart per minute. It is the product of the heart rate, which is the number of beats per minute, and the stroke volume, which is the amount pumped per beat (Cardiac output = heart rate x stroke volume). The cardiac output is usually expressed in liters/minute. The normal cardiac output of a healthy heart is about 5 to 6 liters of blood per minute during rest.
Causes of Decreased Cardiac OutputConditions like myocardial infarction, hypertension, valvular heart disease, congenital heart disease, cardiomyopathy, heart failure, pulmonary disease, arrhythmias, drug effects, fluid overload, decreased fluid volume, and electrolyte imbalance is common causes of decreased cardiac output. Additionally, here are some factors that may be related to decreased cardiac output:
Signs and SymptomsA decrease in cardiac output is characterized by the following manifestations:
Goals and OutcomesThe following are the common goals and expected outcomes for the nursing diagnosis of decreased cardiac output:
Conditions and diseases that use the nursing diagnosis Decreased Cardiac Output:
Nursing Assessment and Rationales for Decreased Cardiac OutputAssessment is required to distinguish possible problems that may have led to decreased cardiac output and name any episode during nursing care. 1. Assess heart rate and blood pressure. 2. Check for peripheral pulses. Perform capillary refill
test (CRT). 3. Auscultate heart sounds for gallops (S3, S4); auscultate breath sounds. 4. Note skin color, temperature, and moisture. 5. Check for any alterations in level of consciousness. 6. Note respiratory rate,
rhythm, and breath sounds. Identify any presence of paroxysmal nocturnal dyspnea (PND), or orthopnea. 7. Assess oxygen saturation with pulse oximetry both at rest and during and after ambulation. 8. Note chest pain. Identify location, radiation, severity, quality, duration, associated manifestations such as nausea, and precipitating and relieving factors. 9. Inspect fluid balance and weight gain. Weigh the patient regularly before breakfast. Check for pedal and sacral edema. 10. Monitor urine output. If the patient is acutely ill, measure hourly urine output and note a decrease in output. 11. Assess beta-type natriuretic peptide (BNP). 12. If hemodynamic monitoring is in place, assess CVP, pulmonary artery diastolic pressure (PADP), pulmonary capillary wedge pressure (PCWP), as well as cardiac output, and cardiac index. 13. Closely monitor for symptoms of heart failure and decreased cardiac output. 14. Assess for reports of fatigue and reduced activity tolerance. 15.
Ascertain contributing factors so an appropriate care plan can be initiated. 16. Monitor electrocardiogram (ECG) for rate, rhythm, and ectopy. 17.
Review results of EKG and chest X-ray. 18. Examine laboratory data, especially arterial blood gases and electrolytes, including potassium. 19. Monitor laboratory tests such as complete blood count, sodium level, and serum creatinine. Nursing Interventions and Rationales for Decreased Cardiac OutputThe following are the therapeutic nursing interventions for a decreased cardiac output which you can use for writing your nursing care plans (NCP): 1. For patients with increased preload, limit fluids and sodium as ordered. 2. Closely monitor fluid intake, including IV lines. Maintain fluid restriction if ordered. 3. If chest pain is present, have the patient lie down, monitor cardiac rhythm, give oxygen, run a strip, medicate for pain, and notify the physician. 4. Place on a cardiac monitor; monitor for dysrhythmias, especially atrial fibrillation. 5. Observe patient for understanding and compliance with medical regimen, including medications, activity
level, and diet. 6. Maintain adequate ventilation and perfusion as in the following:
7. Administer oxygen therapy as prescribed. 8.
Administer medications as prescribed, noting side effects and toxicity. 9. During acute events, ensure the patient remains on bed rest or maintains an activity level that does not compromise cardiac output. 10. Monitor blood pressure,
pulse, and condition before administering cardiac medications such as angiotensin-converting enzyme (ACE) inhibitors, digoxin, and beta-blockers such as carvedilol. Notify the physician if heart rate or
blood pressure is low before holding medications. 11. Monitor bowel function. Provide stool softeners as ordered. Tell the patient to avoid straining when defecating. 12. Identify an emergency plan, including the use of CPR. 13. Advise patient to use a commode or urinal for toileting and avoid using a bedpan. 14. Apply music therapy to decrease anxiety and improve cardiac function. 15. Associate patient with heart failure or
cardiac rehabilitation program for education, evaluation, and guided support to increase activity and rebuild a life. 16.
Explain the importance of smoking cessation and avoidance of alcohol intake. 17. Educate the patient and
significant other about the disease process, complications of the disease process, information on medications, the need for weighing daily, and when appropriate to call a primary care provider. 18. Aid family to adapt daily living patterns to establish life changes that will maintain improved cardiac functioning in the patient. 19. Educate patients on the need for and how to incorporate lifestyle changes. Additional interventions: See additional interventions for decreased cardiac output in our heart failure nursing care plan. Recommended ResourcesRecommended nursing diagnosis and nursing care plan books and resources. Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy.
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