Nursing Diagnosis and Nursing Intervention

NANDA Decreased Cardiac Output

NANDA Definition: Inadequate blood pumped by the heart to meet metabolic demands of the body
Decreased Cardiac output
Defining Characteristics: Altered heart rate/rhythm: arrhythmias (tachycardia, bradycardia); palpitations; EKG changes; altered preload: jugular vein distention; fatigue; edema; murmurs; increased/decreased central venous pressure (CVP); increased/decreased pulmonary artery wedge pressure (PAWP); weight gain; altered afterload: cold/clammy skin; shortness of breath/dyspnea; oliguria; prolonged capillary refill; decreased peripheral pulses; variations in blood pressure readings; increased/decreased systemic vascular resistance (SVR); increased/decreased pulmonary vascular resistance (PVR); skin color changes; altered contractility: crackles; cough; orthopnea/paroxysmal nocturnal dyspnea; cardiac output less than 4 L/min; cardiac index less than 2.5 L/min; decreased ejection fraction, stroke volume index (SVI), left ventricular stroke work index (LVSWI); S3 or S4 sounds; behavioral/emotional:  anxiety ; restlessness
Related Factors: Myocardial infarction or ischemia, valvular disease, cardiomyopathy, serious dysrhythmia, ventricular damage, altered preload or afterload, pericarditis, sepsis, congenital heart defects, vagal stimulation, stress, anaphylaxis, cardiac tamponade
Decreased Cardiac output
NOC Outcomes (Nursing Outcomes Classification)
Suggested NOC Labels
• Cardiac Pump Effectiveness
• Circulatory Status
• Tissue Perfusion: Abdominal Organs
• Tissue Perfusion: Peripheral
• Vital Signs Status
Client Outcomes
  • Demonstrates adequate cardiac output as evidenced by blood pressure and pulse rate and rhythm within normal parameters for client; strong peripheral pulses; and an ability to tolerate activity without symptoms of dyspnea, syncope, or chest pain
  • Remains free of side effects from the medications used to achieve adequate cardiac output
  • Explains actions and precautions to take for cardiac disease
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