Nursing assessment for risk for impaired cardiac output 

Nursing assessment for risk for impaired cardiac output

Assessment	Rationale
Check heart rate or auscultate for any tachycardia or bradycardia.	Monitor ECG of the heart to clearly identify the condition.
Re analyses the patient’s history and finds out causative factors.	Dysrythmic conditions can be solved by finding out the particular cause of it. Lifestyle factors such as smoking, caffeine use, and emotional stress can result in dysrhythmias.
Assess for the need for intravenous access.	An intravenous line is most useful in providing IV medications.
Monitor response of the patient to activity.	Sometimes the cardiac output is normal when the patient is at rest. Cardiac out becomes insufficient when the patient involves in some physical activities.

Interventions	Rationale
If the patient has no symptoms, provide assurance that dysrhythmia is not life-threatening.	Assess the hemodynamic status, it guides the treatment.
Provide comfortable position to the client on bed and chair. Raise legs 20 to 30 degrees.	It decreases oxygen consumption and reduces the workload on the myocardium.
If required administer oxygen supplementation.	It improves cardiac function.
Take hemodynamic measurements at regular intervals (e.g. CVP, PAWP, and left arterial pressure).	These measurements provide accurate assessments of cardiac function and response to any treatment or therapy.
Administer medication as advised by the doctor.	For example, inotropic agents improve cardiac contractility, antiarrhythmic agents improve cardiac contractility, analgesics and anti-anxiety drugs reduces oxygen demand and workload on the myocardium.
Encourage the patient to take rest to reduce the catecholamine-induced stress response. Provide a calm and quiet environment. Provide a schedule of activity to the patient and assign more rest periods. If required assist the patient with activities of daily living.

Client teaching in decreased cardiac output

• Inform the client about his condition, therapies and expected outcome. If possible use various teaching styles and different types of audio-visual materials for clear understanding.
• While teaching the client, emphasize the importance of regular medical check-ups and follow up.
• Ask the client about the medication, dosing and time of taking.
• Inform the client about symptoms in which he/she has to contact the healthcare provider.
• Instruct the client, if possible show a demonstration of self-monitoring of weight, pulse and blood pressure.
• Take vaccines of seasonal influenza, pneumonia or other influenza.
• Discuss individual risk factors. Provide its management
• Smoking cessation
• Stress management techniques
• Energy conservation techniques.
• Advise patient for taking low sodium and low cholesterol diet.

Nursing diagnosis-5: Activity intolerance

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