Nursing Diagnosis: Decreased Cardiac output
Nursing Intervention
Independent:
 Review patient at risk as noted in
related factors and defining
characteristics, as well as individual
with conditions that stress the heart.
 Assess heart rate and blood pressure.
 Note skin color, temperature, and
moisture.
 Check for peripheral pulses, including
capillary refill.
Dependent:
 Give oxygen as indicated by patient
symptoms, oxygen saturation and
ABGs.
Interdependent:
 Restrict or administer fluid (IV/PO).
 Perform periodic hemodynamic
measurements, as indicated (e.g.,
arterial, CVP, pulmonary, and left atrial
pressure and cardiac output).
REFERENCE(S)
Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nurse’s pocket guide: Diagnoses,
prioritized interventions, and rationales. FA Davis. [Link]
CONGESTIVE HEART FAILURE
Rationale
 Acute or chronic conditions may
compromise circulation and place
excessive demands on the heart.
 Most patients have compensatory
tachycardia and significantly low blood
pressure in response to reduced cardiac
output.
 Cold, clammy, and pale skin is
secondary to a compensatory increase
in sympathetic nervous
system stimulation and low cardiac
output and oxygen desaturation.
 Weak pulses are present in
reduced stroke volume and cardiac
output. Capillary refill is sometimes
slow or absent.
 Makes more oxygen available for gas
exchange, assisting to alleviate signs of
hypoxia and subsequent activity
intolerance.
 Provide adequate fluid/free water,
depending on the patient’s needs.
 This test can find problems with how
the heart is working, very important for
patient who need to have surgery.
Nursing Diagnosis: Decreased Cardiac output
Nursing Intervention
Independent:
 Review patient at risk as noted in
related factors and defining
characteristics, as well as individual
with conditions that stress the heart.
 Assess heart rate and blood pressure.
 Note skin color, temperature, and
moisture.
 Check for peripheral pulses, including
capillary refill.
Dependent:
 Give oxygen as indicated by patient
symptoms, oxygen saturation and
ABGs.
Interdependent:
 Restrict or administer fluid (IV/PO).
 Perform periodic hemodynamic
measurements, as indicated (e.g.,
arterial, CVP, pulmonary, and left atrial
pressure and cardiac output).
REFERENCE(S)
Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016).  Nurse’s pocket guide: Diagnoses,
prioritized interventions, and rationales. FA Davis. [Link]
Rationale
 Acute or chronic conditions may
compromise circulation and place
excessive demands on the heart.
 Most patients have compensatory
tachycardia and significantly low blood
pressure in response to reduced cardiac
output.
 Cold, clammy, and pale skin is
secondary to a compensatory increase
in sympathetic nervous
system stimulation and low cardiac
output and oxygen desaturation.
 Weak pulses are present in
reduced stroke volume and cardiac
output. Capillary refill is sometimes
slow or absent.
 Makes more oxygen available for gas
exchange, assisting to alleviate signs of
hypoxia and subsequent activity
intolerance.
 Provide adequate fluid/free water,
depending on the patient’s needs.
 This test can find problems with how
the heart is working, very important for
patient who need to have surgery.