Decreased Cardiac Output The heat fails to pump enough blood to meet the metabolic needs of the body.

The blood flow that supplies the heart is also decreased thus decrease in cardiac output occurs, blood then is insufficient and making it difficult to circulate the blood to all parts of the body thus may cause altered heart rate and rhythm, weakness and paleness NDx: Decreased cardiac output r/t altered heart rate and rhythm AEB bradycardia Assessment Subjective: (none)Objectives: The patient manifested the following:

Planning Nursing Interventions Short Term: 1. Assess for After 3-4 abnormal hours of heart and lung nursing sounds. interventions, 2. Monitor blood the patient pressure and with pale pulse. conjunctiva, will 3. Assess mental nail beds and participate in status and buccal mucosa activities that reduce the level of irregular workload of consciousness. rhythm of the heart. 4. Assess pulse Long Term: patients skin bradycardic temperature pulse rate of 34 After 2-3 days of nursing and peripheral beats/min interventions, pulses. generalized the patient 5. Monitor weakness will be able to results of display laboratory and hemodynamic diagnostic stability. tests. 6. Monitor oxygen saturation and ABGs. 7. Give oxygen as indicated by patient symptoms, oxygen saturation and ABGs. 8. Implement strategies to treat fluid and electrolyte

Rationale Evaluation 1. Allows Short detection of Term:After left-sided nursing heart failure interventions, that may the patient occur with shall have chronic renal participated in failure activities that patients due reduce the to fluid workload of volume the excess as the heart.Long diseased Term:After 2kidneys are 3 days of unable to nursing excrete water. interventions, 2. Patients with the patient renal failure shall have are most been able to often display hypertensive, hemodynamic which is stability. attributable to excess fluid and the initiation of the renninangiotensin mechanism. 3. The accumulation of waste products in the bloodstream impairs

imbalances. 9. Administer cardiac glycoside agents, as ordered, for signs of left sided failure, and monitor for toxicity. 10. Encourage periods of rest and assist with all activities. 11. Assist the patient in assuming a high Fowlers position. 12. Teach patient the pathophysiolo gy of disease, medications 13. Reposition patient every 2 hours 14. Instruct patient to get adequate bed rest and sleep 15. Instruct the SO not to leave the client unattended

oxygen transport and intake by cerebral tissues, which may manifest itself as confusion, lethargy, and altered consciousness . 4. Decreased perfusion and oxygenation of tissues secondary to anemia and pump ineffectivenes s may lead to decreased in temperature and peripheral pulses that are diminished and difficult to palpate. 5. Results of the test provide clues to the status of the disease and response to treatments. 6. Provides information regarding the hearts ability to perfuse distal tissues with oxygenated blood

7. Makes more oxygen available for gas exchange, assisting to alleviate signs of hypoxia and subsequent activity intolerance. 8. Decreases the risk for development of cardiac output due to imbalances. 9. Digitalis has a positive isotropic effect on the myocardium that strengthens contractility, thus improving cardiac output. 10. Reduces cardiac workload and minimizes myocardial oxygen consumption. 11. Allows for better chest expansion, thereby improving pulmonary capacity. 12. Provides the patient with needed

information for management of disease and for compliance. 13. To prevent occurrence of bed sores 14. To promote relaxation to the body 15. To ensure safety and reduce risk for falls that may lead to injury