Nursing Diagnosis Decreased Cardiac Output

Decreased cardiac output is a clinical term used to describe the body’s inability to maintain adequate cardiac output and tissue perfusion. Decreased cardiac output can be caused by reduced stroke volume (i.e., not enough blood is pumping through the heart each beat), decreased contractility of the lower chambers (i.e., hearts not able to pump as much blood per beat), or both.

Nursing Diagnosis Decreased Cardiac Output

1 Nursing Diagnosis Decreased Cardiac Output

In nursing, the term “cardiac output” refers to the amount of blood that is pumped by a heart in one minute. Cardiac output is often used as a metric for evaluating cardiac function, which can be affected by many factors including heart disease and certain medications.

Cardiac output may be decreased for a number of reasons including:

• Heart failure
• Congestive heart failure (CHF)
• Decreased contractility

2 Decreased Cardiac Output

• Decreased cardiac output is a condition in which the heart can’t pump enough blood to meet the body’s needs. This can result from any of the following:
• Heart failure (when the heart muscle is too weak to pump at full capacity)
• Shock (a sudden drop in blood pressure, often caused by severe bleeding or inadequate fluid replacement)
• Acute myocardial infarction (heart attack)

3 Definition

Decreased cardiac output is a nursing diagnosis. It involves a decrease in the amount of blood that is being pumped out by the heart. A patient with decreased cardiac output may experience symptoms such as fatigue, shortness of breath, or swelling in their extremities.

The cause for decreased cardiac output can be many things; if it’s due to heart failure, then the patient will likely have symptoms such as an irregular heartbeat or difficulty breathing. Decreased respiratory rate can also contribute to decreased cardiac output because it means less oxygen gets into your body through your lungs. When you aren’t getting enough oxygenated blood flowing throughout your body, then you might feel dizzy or lightheaded when standing up suddenly (orthostatic hypotension). If this happens and persists after being diagnosed with decreased cardiac output syndrome (DCOS), talk to your doctor immediately because it could be dangerous!

4 * Decision making may be impaired and needs limited to only what is essential. * Determine tolerance of activity, restrict as necessary. * Encourage coughing and deep breathing every 2 hours while patient is awake to expand lungs and increase ventilation. * Maintain orders for oxygen therapy, if ordered. Monitor ABGs and arterial blood pressure during periods of high flow oxygen therapy to prevent carbon dioxide narcosis and respiratory acidosis from developing. Report presence of adventitious breath sounds, cyanosis, restlessness, apprehension, or excessive sleepiness to the physician; these may indicate decreased tissue perfusion.

• Decision making may be impaired and needs limited to only what is essential.
• Determine tolerance of activity, restrict as necessary.
• Encourage coughing and deep breathing every 2 hours while patient is awake to expand lungs and increase ventilation.
• Maintain orders for oxygen therapy, if ordered. Monitor ABGs and arterial blood pressure during periods of high flow oxygen therapy to prevent carbon dioxide narcosis and respiratory acidosis from developing. Report presence of adventitious breath sounds, cyanosis, restlessness, apprehension, or excessive sleepiness to the physician; these may indicate decreased tissue perfusion.

5 Evaluation

An evaluation of the patient’s response to nursing interventions, medications, treatments, diet, exercise and other interventions is essential. The nurse must assess whether these interventions are resulting in desired outcomes for the patient. For example:

6 After 8 hours of nursing interventions the patient will: * Demonstrate restoration of normal skin color (pink). * Demonstrate improvement in heart sounds with auscultation. * Demonstrate resolution of signs & symptoms of heart failure (i.e., SOB, respiratory distress).

After 8 hours of nursing interventions the patient will: * Demonstrate restoration of normal skin color (pink).

• Demonstrate improvement in heart sounds with auscultation.
• Demonstrate resolution of signs & symptoms of heart failure (i.e., SOB, respiratory distress).

Closing

This is a very common nursing diagnosis which needs to be addressed. The patient needs to be monitored closely for any signs of deterioration and any changes in the condition need to be reported immediately.