DECREASED CARDIAC OUTPUT Da Cues te/ tim e S E P T E M B E R 8 , 2 0 1 2 @

Ne ed

Nursing Diagnosis

Objectives of Care

Nursing interventions

Evaluation

Subjective: Objective: Blood pressure of mmHg ECG 12 leads reading: sinus tachycardia Electrolytes: Spinal fracture; spinal compression ; autonomic dysreflexia

Decreased Cardiac output related to decreased ventricular filling

Within 8 hours span of care, the client will not experience further complications brought about by decreased cardiac output as evidenced by: a. Blood pressure within normal range ( 90/60130/90 mmHg); b. Warm, dry skin;
c. Strong bilateral,

1. Monitor vital signs especially blood pressure R: sinus tachycardia and increased arterial blood pressure are seen in early stages. 2. Monitor for clients skin color and temperature. R: cold, clammy skin is secondary to compensatory increase in sympathetic nervous system stimulation and low cardiac output and desaturation. 3. Auscultate lung sounds. Determine any occurrence of paroxysmal nocturnal dyspnea or othopnea. R: crackles after accumulation of fluid secondary to impaired

September 8, 2012 @ 3:00 pm GOAL MET! After 8 hours span of care, the client did not experience further complications brought about by decreased cardiac output as evidenced by: a. Blood pressure of ____

equal peripheral pulses; and d. Clear lung sounds.

ventricular emptying. 7: 0 0 A M 4. Administer medications as ordered (Digoxin, and antihypertensives) R: Digoxin has been widely used as a positive inotrope to increase myocardial contractility. The increased force of systolic contraction cause the ventricles to empty more completely. Antihypetensives will aid the improvement of cardiac output by normalizing the blood pressure. 5. Place client in supine position; semi-Folwlers position R: Supine position increases venous return and promote diuresis. Semifowlers position reduces preload and ventricular filling. 6. Administer humidified oxygen as ordered

mmHg; b. Warm, dry skin; c. Strong bilateral, equal peripher al pulses ; and d. Clear lung sounds hear upon auscultat ion. Judeah G. Salangsang, St. N

R: the failing heart may not be able to respond to increased oxygen demands. 7. Maintain physical rest and emotional rest by providing quiet and relaxed environment. R:to reduce oxygen demand and to prevent increasing cardiac demans. 8. Administer stool softeners as ordered R: straining for a bowel movement further impairs cardiac output. 9. Educate the family and significant others on the importance of following drug regimen, monitoring activity an following deit restrictions (low salt, low fat) R: thorough understanding of condition and what needs to be done help in ensuring that complications

will not occur. References:

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Gulanick, M. & Myers, J. (2007). Nursing Care plans: nursing diagnosis and interventions. 6th edition. Mosby, Elsevier Inc. USA

McKenry, et.al (2007). Mosbys Pharmacology in Nursing. 23rd edition. Mosby, Elsevier, Inc. USA