Nursing diagnoses : Decreased cardiac output

  • Nursing diagnoses
    • Decreased cardiac output related to altered contractility and altered heart rate and rhythm
    • Acute pain related to an imbalance between myocardial O2 supply and demand
    • Anxiety related to perceived or actual threat of death, pain, and/or possible lifestyle changes
    • Activity intolerance related to general weakness secondary to decreased cardiac output and poor lung and tissue perfusion
    • Ineffective health management related to lack of knowledge of disease process, risk factor reduction, rehabilitation, home activities, and medications
  • Planning
    • Overall goals
      • Relief of pain
      • Preservation of heart muscle
      • Immediate and appropriate treatment
      • Effective coping with illness-associated anxiety
      • Participation in a rehabilitation plan
      • Reduction of risk factors
  • Acute interventions: Chronic stable angina
    • Upright position
    • Supplemental oxygen
    • Assess vital signs
    • 12-lead ECG
    • Administer NTG followed by an opioid analgesic, if needed
    • Assess heart and breath sounds
  • Acute care: Acute coronary syndrome
    • Pain: nitroglycerin, morphine, oxygen
    • Continuous monitoring
      • ECG
      • ST segment
      • Heart and breath sounds
      • VS, pulse oximetry, I and O
    • Rest and comfort
      • Balance rest and activity
      • Begin cardiac rehabilitation
    • Anxiety reduction
      • Identify source and alleviate
      • Patient teaching important
    • Emotional and behavioral reaction
      • Maximize patient’s social support systems
      • Consider open visitation

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