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The nursing diagnosis notices the rapid fall in the decreased cardiac output, which usually happens due to low blood pumping by the heart. The condition doesn’t fulfill the requirement of the body’s metabolic demand. Some cardiovascular diseases include heart failure, myocardial infarction, dysrhythmias, and many more problems in the fluid volume. This usually happens due to the drug effect, which in turn decreases the cardiac output.
The cardiac output refers to the amount of blood pumped through the heart in a minute. This refers to the product rate (number of heartbeats in 60 seconds). The stroke volume refers to the total amount of blood pumped out per heartbeat. This cardiac output is expressed in the L/minute. Usually, the normal cardiac output of the heart of healthy persons is nearly 5-6liter per minute.
What are the Causes of Decreased Cardiac Output?
Certain medical conditions like hypertension, myocardial, valvular heart disease, cardiomyopathy, congenital heart disease, pulmonary disease, heart failure, drug effects, arrhythmias, decreased fluid volume, fluid overload, electrolyte imbalance, and many more can result in decreased cardiac output.
In addition, here are some key factors that may result in decreased cardiac output.
- Cardiac muscle disease
- Alteration in rhythm, heart rate, and conduction
- Decreased oxygenation
- Increased after load
- Impaired contractility
- Increased or decreased ventricular filling
What Are the Signs and Symptoms of Decreased Cardiac Output?
The decreased cardiac output shows some of the signs and symptoms, which are as follows:
- Angina
- Abnormal heart sound
- Restlessness and anxiety
- Change in the level of consciousness
- Decreased activity tolerance
- Crackles, orthopnea, dyspnea, tachypnea
- Decreased activity tolerance
- Decreased peripheral pulses, clammy skin, cold and poor capillary refill
- Dysrhythmias
- Decreased arterial oxygen saturation and venous saturation
- Ejection fraction less than 40%
- Hypertension
- Fatigue
- Increased pulmonary artery pressure
- Increased central venous pressure
- Tachycardia
- Edema, weight gain, and decreased urine output.
What Are The Goals of the Diagnosis, and What Are The Outcomes?
These are some of the common goals and outcomes of the nursing diagnosis and its possible outcomes:
- The patient exhibits dry skin exhibit warm eupnea with certain nonexistence of pulmonary crackles.
- The patients may explain the precautions and actions to care for the heart from cardiac diseases.
- The patient will remain side effects free from the medication treatment. This is used to achieve proper cardiac output.
- The patient can endure activities without showing symptoms of breathlessness, hypotension, or chest discomfort, and their blood pressure, vital signs, and rhythm are all within normal ranges.
Nursing Rationales and Assessment for Decreased Cardiac Output
The assessment is the rationale, and assessment may be required to diagnose the problem that can cause decreased cardiac output.
- Assess Blood Pressure and Heart Rate
Individuals with very blood pressure frequently experience compensating tachycardia, which lowers cardiac output. This compensatory reaction initially benefits heart rate, but it may become deleterious if it persists.
- Perform Capillary Refilling Test
Low cardiac output & stroke volume are indicators of weak pulses. Sometimes capillary refill is nonexistent or very sluggish. Recent studies show that various environmental variables influence the capillary refill test measurement.
- Auscultate Heart Sounds for Gallops (Auscultate Breathing Sound)
Heart failure may manifest as a fresh commencement of a gallop rhythm, tachycardia, and tiny buzzes in the pulmonary bases. The individual will have acute dyspnea and harsh beeps on inhalation if they develop respiratory failure. S3 is a class indicator for left ventricular failure and denotes diminished left ventricular evacuation. The left ventricle’s lower compliance in S4 compromises tidal filling.
- Look for the Alternations in Consciousness Level
Anger, restlessness, and trouble focusing are symptoms of reduced brain oxygenation and hypoxia. Reduced cerebral circulation is particularly dangerous for elderly people. Adjustments in blood flow to the brain can result from variations in cardiac output, whether transient or chronic.
- Note Temperature, Skin Color, and Moisture
Low cardiac output, oxygen osmotic diuresis, and a compensatory rise in autonomic nerve activation are the main causes of cold, clammy, and pallid skin.
Bottom Line
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