Decreased cardiac output

Decreased cardiac output

Decreased cardiac output


Nursing Diagnosis Definition

The nursing diagnosis for Decreased Cardiac Output is defined by NANDA International as "a decrease in the ability of the heart to pump blood to meet the metabolic needs of the body as evidenced by changes in heart rate, blood pressure, central venous pressure, pulmonary artery pressure, and cardiac output measurements." This diagnosis is applicable when there are observable alterations in cardiovascular parameters reflecting an impaired cardiac pumping function.

Defining Characteristics

  • Chest pain: Patient reports discomfort or pain in the chest area. This can be indicative of myocardial ischemia or other cardiac-related issues.
  • Dyspnea: Patient experiences difficulty in breathing. Shortness of breath may result from inadequate cardiac output leading to insufficient oxygen supply to tissues.
  • Fatigue: Patient reports an overwhelming sense of tiredness or exhaustion. Reduced cardiac output may lead to insufficient energy delivery to meet the body's metabolic demands.
  • Hypotension: Observable low blood pressure readings. A drop in blood pressure may be associated with decreased cardiac pumping ability.
  • Orthopnea: Difficulty breathing while lying flat. This may be due to increased venous return when lying down, putting additional strain on the heart.

Related Factors

  • Anemia: Decreased red blood cell count affecting oxygen transport. Anemia can contribute to decreased oxygen-carrying capacity, impacting overall tissue perfusion.
  • Cardiac arrhythmias: Irregular heart rhythms impacting effective pumping. Arrhythmias can disrupt the coordinated contractions of the heart, reducing its efficiency.
  • Heart disease: Structural or functional abnormalities affecting cardiac output. Conditions such as myocardial infarction or heart failure can impair the heart's ability to pump effectively.
  • Hypertension: Elevated blood pressure impacting cardiac workload. Chronic hypertension can lead to increased afterload, affecting the heart's efficiency in pumping blood.
  • Hypovolemia: Reduced blood volume affecting preload and cardiac output. Insufficient blood volume can compromise the heart's ability to fill adequately, reducing stroke volume and cardiac output.

Risk Population

  • Individuals at a higher risk for developing Decreased Cardiac Output include:
  • Elderly adults: Age-related changes and potential cardiovascular issues increase susceptibility. Aging can lead to a decline in cardiac function and structural changes, making the elderly more prone to decreased cardiac output.
  • Individuals with heart disease: Pre-existing cardiac conditions can compromise cardiac output. Conditions such as heart failure, myocardial infarction, or valvular disorders contribute to impaired pumping ability and, consequently, decreased cardiac output.
  • Individuals with hypertension: Elevated blood pressure may contribute to decreased cardiac function over time. Chronic hypertension can lead to structural changes in the heart, affecting its ability to pump blood efficiently and potentially resulting in decreased cardiac output.
  • Individuals with hypovolemia: Reduced blood volume can negatively impact preload and cardiac output. Conditions such as dehydration, hemorrhage, or inadequate fluid intake can lead to decreased blood volume, affecting the heart's ability to pump an adequate amount of blood to meet the body's needs.
  • Individuals on certain medications, such as beta blockers or ACE inhibitors: Medications affecting heart rate and contractility can influence cardiac output. Beta blockers and ACE inhibitors, commonly prescribed for cardiovascular conditions, may alter the heart's pumping capacity, leading to a potential decrease in cardiac output.

Associated Problems

  • Acute renal failure: Sudden kidney dysfunction due to reduced blood flow.
  • Hypoxia: Inadequate oxygen supply to tissues.
  • Infections: Increased susceptibility to infections due to compromised cardiac function.
  • Shock: Inadequate tissue perfusion leading to a life-threatening condition.
  • Tissue perfusion problems: Impaired blood flow affecting various tissues and organs.

Suggestions for Use

  • Monitor vital signs and cardiac output measurements: Regularly assess and record vital signs, including cardiac output measurements, to track changes and responsiveness to interventions.
  • Administer medications as ordered, such as inotropes or vasopressors, to increase cardiac output: Implement pharmaceutical interventions to enhance cardiac performance.
  • Assess for and address any underlying conditions that may be contributing to decreased cardiac output, such as anemia or hypovolemia: Investigate and manage contributing factors to improve cardiac function.
  • Educate patient and family on lifestyle changes to promote cardiac health: Provide information on lifestyle modifications to support cardiac well-being.
  • Implement measures to prevent infections, such as proper hand hygiene and aseptic technique: Take preventive actions to reduce infection-related complications.

Suggested Alternative Nursing Diagnosis

  • Ineffective Tissue Perfusion: Impaired blood flow leading to inadequate oxygenation of tissues.
  • Impaired Gas Exchange: Altered respiratory function affecting oxygen and carbon dioxide exchange.
  • Ineffective Cardiac Tissue Perfusion: Impaired blood flow specifically affecting cardiac tissue.
  • Acute Confusion: Sudden onset of cognitive impairment often related to decreased oxygenation.
  • Impaired Physical Mobility: Limitations in physical movement due to decreased cardiac function.

Usage Tips

  • This diagnosis should be used in conjunction with other diagnoses that may be contributing to the decreased cardiac output, such as anemia or hypovolemia: Consider a holistic approach to address all contributing factors simultaneously.
  • It is important to monitor the patient's response to interventions and adjust as necessary: Continuously evaluate the effectiveness of interventions and adapt the care plan accordingly.
  • It is also important to consider the patient's overall cardiac history and any previous cardiac events they may have experienced: Take into account the patient's medical history to tailor interventions appropriately.
  • In cases where the patient is experiencing severe decreased cardiac output, referral to a cardiologist may be necessary: Collaborate with specialists for comprehensive cardiac management in severe cases.

NOC Results

  • Cardiac Output: Continuous monitoring of the patient's cardiac output, which indicates the effectiveness of interventions and overall cardiac function.
  • Heart Rate: Continuous monitoring of the patient's heart rate, reflecting changes in cardiac output and overall cardiac function.
  • Blood Pressure: Continuous monitoring of the patient's blood pressure, indicating changes in cardiac output and overall cardiac function.
  • Tissue Perfusion: Monitoring the patient's tissue perfusion, which can be affected by decreased cardiac output.

NIC Interventions

  • Cardiac Medications Management: Administering medications as ordered to increase cardiac output and improve overall cardiac function.
  • Cardiac Monitoring: Monitoring the patient's cardiac output, heart rate, and blood pressure to assess the effectiveness of interventions and detect any changes in cardiac function.
  • Fluid Management: Managing the patient's fluid levels to promote optimal cardiac function and prevent hypovolemia.
  • Infection Control: Implementing measures to prevent infections, such as proper hand hygiene, to protect the patient's overall health and cardiac function.

Isabella White

Hello to all nursing enthusiasts! I'm Isabella White and I'm thrilled to welcome you to this space dedicated to the exciting world of nursing. Let me share a little about myself and what we can expect together on this journey. About Me: Nursing is more than just a profession to me, it's a calling. When I'm not caring for my patients or learning more about health and wellness, you'll find me enjoying the great outdoors, exploring new trails in nature, or savoring a good cup of coffee with close friends. I believe in the balance between caring for others and self-care, and I'm here to share that philosophy with you. My Commitment to You: In this space, I commit to being your reliable guide in the world of nursing. Together, we'll explore health topics, share practical tips, and support each other on our journeys to wellness. But we'll also celebrate life beyond the hospital walls, finding moments of joy in the everyday and seeking adventures that inspire us to live fully. In summary, this is a place where nursing meets life, where we'll find support, inspiration, and hopefully a little fun along the way. Thank you for joining me on this exciting journey. Welcome to a world of care, knowledge, and connection! Sincerely, Isabella White

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