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Decreased Cardiac Output – Nursing Care Plan for Angina Pectoris

Decreased Cardiac Output

NANDA Definition :

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

Related Factors:

Myocardial infarction or ischemia, valvular disease, cardiomyopathy, serious dysrhythmia, ventricular damage, altered preload or afterload, pericarditis, sepsis, congenital heart defects , vagal stimulation, stress, anaphylaxis, cardiac tamponade

Angina Pectoris

Angina Pectoris

Angina pectoris is the result of myocardial ischemia caused by an imbalance between myocardial blood supply and oxygen demand. Angina is a common presenting symptom (typically, chest pain) among patients with coronary artery disease. A comprehensive approach to diagnosis and to medical management of angina pectoris is an integral part of the daily responsibilities of health care professionals.

NOC Outcomes (Nursing Outcomes Classification)
Suggested NOC Labels

Cardiac Pump Effectiveness
Circulatory Status
Tissue Perfusion: Abdominal Organs
Tissue Perfusion: Peripheral
Vital Signs Status

NIC Interventions (Nursing Interventions Classification)
Suggested NIC Labels

Cardiac Care: Acute
Circulatory Care

Client Outcomes

Demonstrates adequate cardiac output as evidenced by blood pressure and pulse rate and rhythm within normal parameters for client; strong peripheral pulses; and an ability to tolerate activity without symptoms of dyspnea, syncope, or chest pain
Remains free of side effects from the medications used to achieve adequate cardiac output
Explains actions and precautions to take for cardiac disease.

Nursing Intervention for Angina Pectoris

  1. Monitor vital signs, eg heart rate, blood pressure.
    Rationale: Tachycardia can occur because of pain, anxiety, hypoxemia, and decreased cardiac output. Changes also occur in blood pressure (hypertension or hypotension) due to cardiovascular response.
  2. Record the color and the presence / quality of the pulse.
    Rationale: decreased peripheral circulation when cardiac output falls, making skin color pale or gray (depending on the level of hypoxia) and decreased strength of peripheral pulses.
  3. Maintain bed rest in a comfortable position during the acute episode.
    Rationale: Lowering the oxygen consumption / demand, lowering employment and risk of myocardial decompensation.
  4. Provide supplemental oxygen as needed
    Rationale: Increase the supply of oxygen to the need to improve myocardial contractility, decrease ischemia, and lactic acid levels.