ASUHAN KEPERAWATAN

Nursing Diagnosis for Decreased Cardiac Output

NANDA Definition: Inadequate blood pumped by the heart to meet the metabolic demands of the body

Common causes of reduced cardiac output include myocardial infarction, hypertension, valvular heart disease, congenital heart disease, cardiomyopathy, pulmonary disease, arrhythmias, drug effects, fluid overload, decreased fluid volume, and electrolyte imbalance. Geriatric patients are especially at risk because the aging process causes reduced compliance of the ventricles, which further reduces contractility and cardiac output. Patients may have acute, temporary problems or experience chronic, debilitating effects of decreased cardiac output. Patients may be managed in an acute, ambulatory care, or home care setting. This care plan focuses on the acute management.

Related Factors:

• Increased or decreased ventricular filling (preload)
• Alteration in afterload
• Impaired contractility
• Alteration in heart rate, rhythm, and conduction
• Decreased oxygenation
• Cardiac muscle disease

Defining Characteristics:

• Variations in hemodynamic parameters (blood pressure [BP], heart rate, central venous pressure [CVP], pulmonary artery pressures, venous oxygen saturation [SVO2], cardiac output)
• Arrhythmias, electrocardiogram (ECG) changes
• Rales, tachypnea, dyspnea, orthopnea, cough, abnormal arterial blood gases (ABGs), frothy sputum
• Weight gain, edema, decreased urine output
• Anxiety, restlessness
• Syncope, dizziness
• Weakness, fatigue
• Abnormal heart sounds
• Decreased peripheral pulses, cold clammy skin
• Confusion, change in mental status
• Angina
• Ejection fraction less than 40%
• Pulsus alternans

Expected Outcomes Nursing Diagnosis for Decreased Cardiac Output

• Patient maintains BP within normal limits; warm, dry skin; regular cardiac rhythm; clear lung sounds; and strong bilateral, equal peripheral pulses.

Nursing Diagnosis for Decreased Cardiac Output

NOC Outcomes (Nursing Outcomes Classification)
Suggested NOC Labels

• Cardiac Pump Effectiveness
• Circulation Status
• Knowledge: Disease Process
• Knowledge: Treatment Program

NIC Interventions (Nursing Interventions Classification)
Suggested NIC Labels

• Cardiac Care
• Hemodynamic Regulation
• Teaching: Disease Process