Date/ Cues Need Nursing Patient Outcome Planning of Implementation Evaluation

Time Diagnosis Intervention

A Objective: A Risk for decrease After 6 hours of 1. Monitor 1 August 17,
U - Previously C cardiac output nursing intervention, hemodynamic 2021 @ 2:30
G diagnosed T related to the patient will be able parameters PM
U with I reduced coronary to maintain adequate R: Hypotension,
S coronary V blood flow. cardiac output increased GOAL MET
T artery I manifested by: cardiac rate and
disease T Rationale: a. Hemodynamic increased CVP After 6 hours of
17, (CAD) Y Narrowing of the parameters in are indicative nursing
2021 - ECG arterial lumen, normal range sign of intervention, the
results: & thrombus  Blood decrease patient was able
@  Elevated formation, and pressure cardiac output to maintain
ST E obstruction of (110/70 – and are at risk adequate
7:30 segment X blood flow to the 130/90 of cardiogenic cardiac output
AM (0.6 E myocardium mmHg) shock. manifested by:
seconds R cause inadequate  Cardiac rate 2. Assess skin 4
after the J C blood supply that (60-100 color and a. Hemodyna
point) I deprives cardiac bpm) temperature mic
 Ventricula S muscle cells of  CVP (2 – 6 R: Cold, parameters
r E oxygen needed to mmHg) clammy and in normal
fibrillation function properly. b. Oxygen pale skin is range.
- Laboratory P If this deprivation saturation in secondary to  BP
tests results A in oxygen normal range compensatory (110/80 –
 Positive T continues, it can (95% - 100%) increase in 120/90
Troponin I T cause irreversible c. Brisk capillary sympathetic mmHg)
(0.50) E damage and refill nervous system  HR (89 –
 Increased R death of d. Strong stimulation, low 95 bpm)
CK-MB N myocardial cells peripheral cardiac output  CVP (4
level (6.0 that leads to pulses and oxygen mmHg)
persistent low desaturation.
 ng/ml cardiac output e. Skin is pinkish 3. Check 5 b. O2 sat
 Increased and then heart in color and peripheral (99% -
Myoglobin failure. (Hinkle, warm to touch pulses and 100%)
level (83 J.L. & Cheever, capillary refill. c. With brisk
ng/ml K.H., 2014, p. R: Weak pulses capillary
- Crackles 731) and slow refill in both
auscultated capillary refill hands and
in both Reference: are signs of feet
lobes Hinkle, J.L. & dehydration d. Strong
Cheever, K.H. which reduces peripheral
(2014). Brunner & volume of pulses as
Suddarth's circulation and palpated
Textbook of decrease e. Skin is
Medical-Surgical cardiac output. pinkish and
Nursing (14th 4. Inspect fluid 6 warm to
ed.). balance and touch
Philadelphia: weight gain.
Wolters Kluwer. R:
Ignatavicius, Compromised
D.D., Workman, regulatory
M.L., & Rebar, mechanisms
C.R. (2018) may result in
fluid and sodium
retention.
5. Assess oxygen 2
saturation with
pulse oximetry.
R: An alteration
in oxygen
saturation is
one of the
earliest signs of
decrease
 cardiac output.
6. Monitor ECG for
rate, rhythm and 3
ectopy.
R: Cardiac
dysrhythmias
can
compromise
cardiac output.
7. Position client
on bed in Semi 9
fowler’s
position.
Decrease
unneeded
activities and
suggest bed
rest.
R: This will
facilitate
oxygenation
and decreases
body’s
metabolic needs
thus reducing
workload of the
heart.
8. Administer O2 if
needed. 11
R: To meet
increased
metabolic
demands and
 facilitate
oxygenation.
9. Administer
diuretics as 7
ordered.
R: Reduces
excessive fluids
in the body
particularly in
the lungs.
10. Monitor
electrolyte level 8
including
potassium.
R: Hypokalemia
is common in
heart patients
because of
diuretic use.
11. Provide comfort
measures such 10
as position
change, and
back rub and
tapping.
R: Improve
relaxation and
facilitate
drainage of .
secretions.
References:

Hinkle, J.L. & Cheever, K.H. (2014). Brunner & Suddarth's Textbook of Medical-Surgical Nursing (14th ed.). Philadelphia: Wolters Kluwer.

Ignatavicius, D.D., Workman, M.L., & Rebar, C.R. (2018)

NANDA – Nursing Diagnosis (2015). Risk for Decreased Cardiac Output NCP Morbus Basedow. Retrieved August 31, 2021 from
https://nanda-diagnosis.blogspot.com/2012/11/risk-for-decreased-cardiac-output-ncp.html

Somantri, I. (2011). Nursing Diagnosis and 11 Gordon’s Functional Health Patterns. Retrieved August 31, 2021 from
https://irmanweb.wordpress.com/2011/03/11/nursing-diagnosis-and-11-gordons-functional-health-patterns/

Wayne, G., BSN, R.N. (2021). Decreased Cardiac Output Nursing Care Plan. Retrieved August 31, 2021 from
https://nurseslabs.com/decreased-cardiac-output/