Risk for Decreased Cardiac Output - NCP for Heart Arrhythmias

Nursing Care Plan for Heart Arrhythmias

Heart rhythm disorder or arrhythmia is a frequent complication of myocardial infarction. Arrhythmia or dysrhythmia is the change in frequency and heart rhythm caused by abnormal electrolyte conduction or automatic (Doenges, 1999).

Arrhythmias arising from myocardial cells electrophysiological changes. These electrophysiological changes manifest as changes in action potential shape ie graphic record of electrical activity of cells (Price, 1994).

Heart rhythm disturbances are not only limited to the irregularity in heart rate but also including rate and conduction disorders (Hanafi, 1996).

Nursing Diagnosis : Risk for Decreased Cardiac Output related to electrical conduction disturbances, decreased myocardial contractility.

Outcomes:

• Maintain / increase cardiac output adequately evidenced by blood pressure / pulse in the normal range, adequate urine output, the same palpable pulse, normal mental status.
• Showed a decrease in the frequency / no dysrhythmias.
• Participate in activities that decrease myocardial work.

Interventions :

1. Feel the pulse (radial, femoral, dorsalis pedis) record the frequency, regularity, amplitude and symmetrical
2. Auscultation of heart sounds, note the frequency, rhythm. Note the extra heart rate, decreased pulse.
3. Monitor vital signs and assess adequacy of cardiac output / tissue perfusion.
4. Determine the type of dysrhythmia and rhythm note: tachycardia; bradycardia; atrial dysrhythmias; ventricular dysrhythmias; block.
5. Provide quiet environment. Assess the reasons for limiting the activity during the acute phase.
6. Demonstrate / encourage use of behavioral stress management eg deep breathing relaxation, guided imagery.
7. Assess pain report, note the location, duration, intensity and factor relievers / ballast. Note the presence of non-verbal pain, for example; frown face, crying, changes in blood pressure.
8. Prepare / do CPR as indicated.
9. Monitor laboratory tests, for example; electrolyte.
10. Provide supplemental oxygen as indicated.
11. Give medications as indicated: potassium, anti dysrhythmias.
12. Prepare for elective cardioversion aids.
13. Help installing / maintaining the function of the pacemaker.
14. Enter / maintain input IV - Prepare for invasive diagnostic procedures.
15. Prepare for the installation of automatic cardioverter or defibrillator.

Read More..

Decreased Cardiac Output Congestive Heart Failure Nursing Care Plan

Decreased Cardiac Output NANDA Definition:

Inadequate blood pumped by the heart to meet metabolic demands of the body

Nursing Diagnosis:

Decreased cardiac output related to Altered heart rate and rhythm AEB bradycardia

characterized by:

• with pale conjunctiva, nail beds and buccal mucosa
• irregular rhythm of the pulse
• bradycardic
• pulse rate of 34 beats / min
• generalized weakness

Short-Term Objectives:
the patient Will Participate in activities That Reduced the workload of the heart.

Long-Term Objectives:
Will the patient be Able to display hemodynamic stability.

Nursing Interventions Decreased Cardiac Output Congestive Heart Failure:

1. Auscultation apical pulse; examine the frequency, the heart rhythm.
Rational: Usually tachycardia (even at rest) to compensate for the decrease in ventricular contractility.

2. Record the heart sounds.
Rational: S1 and S2 may be weak due to decreased pumping action. Gallop rhythm common (S3 and S4) is generated as the flow of blood to the porch of distension. Mur-mur may indicate incompetence / stenosis of the valve.

3. Palpation of peripheral pulses.
Rational: The decrease in cardiac output may show decreased radial artery, popliteal, dorsalis, pedis and posttibial. The pulse may disappear fast or irregular pulse to be palpable and alternan.

4. Monitor blood pressure.
Rational: In Congestive Heart Failure early, moderate or chronic blood pressure may increase. In Congestive Heart Failure-up body could no longer compensate and hypotension can not be normal again.

5. Assess against pale skin and cyanosis.
Rational: Pale, indicating reduced peripheral perfusion secondary to cardiac output adekutnya not; vasoconstriction and anemia. Cyanosis may occur as refrakstori Congestive Heart Failure. The area of ​​pain is often colored blue striped atu because of increased venous congestion.

6. Give supplemental oxygen by nasal cannula / mask and drugs as indicated (collaboration).
Rationale: Increased dosage of oxygen to the need to counter the effects of myocardial hypoxia / ischemia.

Read More..