Decreased Cardiac Output

Definition: Inadequate blood pumped by the heart to meet the metabolic demands of thebody. [Note: In a hypermetabolic state, although cardiac output may be within normal range, it may still be inadequate to meet the needs of the body’s tissues.


Cardiac output and tissue perfusion are interrelated, although there are differences. When cardiac output is decreased, tissue perfusion problems will develop; however, tissue perfusion problems can exist without decreased cardiac output.]


RELATED FACTORS

  • Altered heart rate/rhythm, [conduction]
  • Altered stroke volume: altered preload [e.g., decreased venous return]; altered afterload [e.g., systemic vascular resistance]; altered contractility [e.g., ventricular-septal rupture, ventricular aneurysm, papillary muscle rupture, valvular disease]


DEFINING CHARACTERISTICS

Subjective

  • Altered heart rate/rhythm: Palpitations
  • Altered preload: Fatigue
  • Altered afterload: Shortness of breath/dyspnea
  • other on the book..

Objective

  • Altered heart rate/rhythm: [Dys] arrhythmias (tachycardia, bradycardia); ECG changes
  • Altered preload: Jugular vein distention (JVD), edema, weight gain, increased/decreased central venous pressure (CVP), increased/decreased pulmonary artery wedge pressure (PAWP), murmurs.
  • Behavioral/emotional: Restlessness
  • other on the book...


ACTIONS/INTERVENTIONS

Sample NIC linkages:

  • Hemodynamic Regulation: Optimization of heart rate, preload, afterload, and contractility
  • Cardiac Care: Limitation of complications resulting from an imbalance between myocardial oxygen supply and demand for a patient with symptoms of impaired cardiac function.

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