DECREASED CARDIAC OUTPUT

Decreased Cardiac Output related to systolic dysfunction secondary to impaired Myocardial Oxygenation

Nursing Assessment	Nursing Diagnosis	Goal	Nursing Intervention	Rationale	Evaluation
Subjective Data: Chest tightness/palpitation Productive cough Shortness of breath Diaphoresis Cool, clammy skin Weakness, fatigue & lethargy Swelling of hands & feet Facial puffiness Objective Data: Skin looks pale & edematous Diminished Peripheral Pulses Capillary refill time prolonged Vital signs show increased heart & Respiratory rate & BP decreased Presence of Respiratory crackles Presence of Cardiac Murmurs ECG show dysrhythmias Oxygen saturation decreased ABG Analysis show Respiratory acidosis/Metabolic Acidosis	Decreased Cardiac Output related to systolic dysfunction secondary to impaired Myocardial Oxygenation	Client maintains a normal Cardiac Output with normal vital Signs & Hemodynamic parameters	Assess the vital Signs & hemodynamic parameters like cardiac Output, intra arterial Pressure, Central venous pressure & pulmonary artery pressure continually	To monitor the hemodynamic status of the client & start immediate interventions	Client's cardiac output was increased as evidenced by normal cardiac output & stable dynamic parameters.
			Monitor the ECG & Saturation levels continually	To identify the need for oxygen therapy & provide interventions
			Monitor I/O chart daily	To identify Renal function as decreased cardiac output can impair Renal Perfusion
			Provide Strict bed rest & elevate the head end of the bed	To decrease Myocardial Oxygen demand & improve cardiac contraction
			Administer Oxygen therapy as indicated	To improve oxygenation to the Lungs & improve Myocardial Perfusion
			Administer Digitalis therapy as Prescribed	To improve contractility & increase cardiac Output
			Administer diuretics like thiazide, loop or potassium sparing diuretics as Prescribed	To decrease the fluid Overload & aid in cardiac contractility
			Administer Vasodilators like Nitroglycerine, hydralazine & isosorbide dinitrate as prescribed	To dilate the arteries & veins and reduce afterload thereby Increasing Cardiac Output
			Administer Nesiritide as Prescribed	To cause rapid vasodilation & increased Stroke volume
			Administer antiarrhythmic drugs & positive inotropic agents as Prescribed	To treat cardiac dysrhythmias
			Administer beta-blockers & ACE inhibitors as prescribed	To improve the ejection fraction & increase cardiac Output
			Assess the need for emergency Surgical or Invasive Interventions like IABP & Ventricular Assist devices & prepare the client for the Procedure	To treat the cause and improve Oxygenation & aid in gaseous Exchange

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