Nanda Nursing Diagnosis - Nursing Care Plan

Nanda - Decreased Cardiac Output - NCP CHF

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Congestive heart failure is a condition in which the heart's function as a pump is inadequate to meet the body's needs.

Congestive heart failure can be caused by:
  • diseases that weaken the heart muscle,
  • diseases that cause stiffening of the heart muscles, or
  • diseases that increase oxygen demand by the body tissue beyond the capability of the heart to deliver adequate oxygen-rich blood.

The symptoms of congestive heart failure vary, but can include fatigue, diminished exercise capacity, shortness of breath, and swelling.

The treatment of congestive heart failure can include lifestyle modifications, addressing potentially reversible factors, medications, heart transplant, and mechanical therapies.


Nursing Diagnosis for CHF : Decreased Cardiac Output related to myocardial contractility

Decreased Cardiac Output Definition: Inadequate blood pumped by the heart to meet metabolic demands of the body

Goal:

Will maintain optimal cardiac ouput aeb vital signs within acceptable limits, no s/sx of decreased cardiac output.

Expected outcomes:
  • Clients have the heart pump effectively.
  • Circulation status of tissue perfusion and vital signs were normal status.
  • Shows adequate cardiak output indicated by blood pressure, pulse, normal rhythm, strong peripheral pulses, perform activities without dyspnoea and pain.

Nursing Interventions and Rationale :

1. Monitor vital signs are: heart rate, blood pressure.
2. Evaluation of mental status, progress notes chaos, disorientation.
3. Note the color, presence / quality of the pulse.
4. Auscultation of breath sounds and heart sounds. Listen to the murmur.
5. Maintain bedrest in a comfortable position during the acute period.
6. Provide adequate rest periods / adequate. Assess the form of self-care activities, if indicated.
7. Assess signs and symptoms of CHF.

Rationale :

1. Tachycardia may exist because of pain, anxiety, hypoxemia, and decreased cardiac output. Changes may also occur in blood pressure (hypertension or hypotension) due to cardiac response.
2. Decreased cerebral perfusion may lead to changes in observation / recognition in sensory.
3. Decreased peripheral circulation, when cardiac output decreases, 4. create / make colors pale / gray for the skin (depending on the degree of hypoxia) and a decrease in the strength of peripheral pulses.
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