Nursing Diagnosis : Decreased Cardiac Output
Inadequate blood pumped by the heart to meet metabolic demands of the body
Decreased cardiac output related to Altered heart rate and rhythm AEB bradycardia
- with pale conjunctiva, nail beds and buccal mucosa
- irregular rhythm of the pulse
- pulse rate of 34 beats / min
- generalized weakness
the patient Will Participate in activities That Reduced the workload of the heart.
Will the patient be Able to display hemodynamic stability.
Nursing Interventions Decreased Cardiac Output Congestive Heart Failure:
1. Auscultation apical pulse; examine the frequency, the heart rhythm.
Rational: Usually tachycardia (even at rest) to compensate for the decrease in ventricular contractility.
2. Record the heart sounds.
Rational: S1 and S2 may be weak due to decreased pumping action. Gallop rhythm common (S3 and S4) is generated as the flow of blood to the porch of distension. Mur-mur may indicate incompetence / stenosis of the valve.
3. Palpation of peripheral pulses.
Rational: The decrease in cardiac output may show decreased radial artery, popliteal, dorsalis, pedis and posttibial. The pulse may disappear fast or irregular pulse to be palpable and alternan.
4. Monitor blood pressure.
Rational: In Congestive Heart Failure early, moderate or chronic blood pressure may increase. In Congestive Heart Failure-up body could no longer compensate and hypotension can not be normal again.
5. Assess against pale skin and cyanosis.
Rational: Pale, indicating reduced peripheral perfusion secondary to cardiac output adekutnya not; vasoconstriction and anemia. Cyanosis may occur as refrakstori Congestive Heart Failure. The area of pain is often colored blue striped atu because of increased venous congestion.
6. Give supplemental oxygen by nasal cannula / mask and drugs as indicated (collaboration).
Rationale: Increased dosage of oxygen to the need to counter the effects of myocardial hypoxia / ischemia.