Assessment Explanation of the Problem
Inadequate blood pumped by the Short Term:
Subjective: heart to meet the metabolic
“naulawak ay biglaan” as demands of the body. Common
verbalized by the patient. causes of reduced cardiac output
include myocardial infarction,
hypertension, valvular heart
disease, congenital heart
Objective: disease, cardiomyopathy,
 Chest pain pulmonary disease, arrhythmias,
 Poor cardiac reserve drug effects, fluid overload,
decreased fluid volume, and
 Generalized weakness
electrolyte imbalance. Older
 Fatigue
patients are especially at risk
because the aging process
Vital signs:
causes reduced compliance of
BP: 160/100 mmHg
the ventricles, which further
HR: 62 bpm
reduces contractility and cardiac
RR: 22 cpm
output.
Reference:
Nursing Diagnosis
Hinkle J.L. Cheever K.H. (2017)
Decreased cardiac output related Brunner an Suddath’s textbook of cardiac output as evidenced by
to decrease circulation in the Medical Surgical Nursing, Wolters blood pressure and pulse rate
heart as manifested by chest pain Kluwer, New York. US.
and fatigue.
Planning Nursing Interventions
Diagnosis:
Within 8 hours of nursing
intervention, the patient will be
able to participate in activities
that reduce the workload of the
heart such as therapeutic
medication regimen and
balanced activity/ rest plan.
Long Term:
Within 3 days of nursing
intervention, the patient will be
able to demonstrates adequate
within normal parameters for
patient; and an ability to tolerate
activity without chest pain.
Rationale Evaluation
Short Term:
 Monitor vital signs  To determine present The goal was met, within 8
especially the blood condition of the patient hours of nursing intervention, the
pressure, respiratory patient was able to participate in
rate, and pulse rate. activities that reduce the
workload of the heart such as
 Assess patient’s  Cold, pale and clammy therapeutic medication regimen
condition like capillary skin is secondary to and balanced activity/ rest plan.
refill, skin color, compensatory increase
temperature, and in sympathetic nervous
moisture system stimulation and
low cardiac output.
Capillary refill is slow,
sometimes absent
 Assess oxygen  Change in oxygen
saturation using pulse saturation is one of the
oximeter earliest indicators of Long Term:
reduced cardiac output
The goal was met, within 3
 Raise side rails of the  Safety of the patient days of nursing intervention, the
patient’s bedside patient was able to demonstrates
adequate cardiac output as
evidenced by blood pressure and
 Position in high fowler’s pulse rate within normal
 To facilitate lung parameters for patient; and an
expansion
ability to tolerate activity without
chest pain.
 ECG monitoring as
ordered by the physician  Cardiac dysrhythmias
may occur from low
perfusion, acidosis or
hypoxia. Older patients
are especially sensitive
to the loss of atrial kick in
atrial fibrillation.
  Monitor hemodynamic
parameters at prescribed
level
Therapeutic:
 Close monitoring of these
parameters guides
titration of fluids and
medication.

 Administer oxygen  To help in oxygen –

carbon dioxide exchange

 Administer medication as  Useful in the treatment of

directed by the physician HF by blocking the
such as beta – cardiac effects of chronic
adrenergic agents adrenergic stimulation.
Educative:

 Explain symptoms and  Though understanding

interventions for
decreased cardiac output
related to etiological
factors
for of specific causes for
each patient’s disease is
necessary for appropriate
follow through of
treatment plan

 Explain the drug  Information provides

regimen, purpose, dose, rationale for therapy and
and side effects aids the patient in
assuming responsibility
for self-care later.

 Explain diet restrictions  Diet changes and

for example, with respect restrictions can be
to fluid and sodium intake especially challenging to
patients and may require
ongoing monitoring
Reference:

Herdan, H.T., (2020) NANDA

International Nursing Diagnosis:
Definitions and Classifications
2018-2020 11th Edition.