Care Plan for Potential Decreased Cardiac Output

Category / Primary Body System

• Cardiovascular System

Problem

• Resident has potential for decreased cardiac output.

Goal

• Resident's cardiac output will remain adequate to meet physiological needs for 90 days.

Plan/Approach

1. Monitoring and Assessment

   • Monitor vital signs per protocol (blood pressure, heart rate, respiratory rate, oxygen saturation)
   • Monitor for signs of decreased cardiac output, such as increased heart rate, abnormal heart sounds, changes in blood pressure, decreased urine output, chest pain, diminished peripheral pulses, ashen skin, diaphoresis, orthopnea, weakness, and fatigue

2. Medication and Treatment

   • Administer medications as ordered to manage underlying cardiac conditions
   • Monitor lab results as ordered (e.g., electrolytes, cardiac enzymes, complete blood count)

3. Fluid and Oxygen Management

   • Follow fluid restrictions as ordered to prevent fluid overload
   • Administer oxygen as ordered or as needed to maintain adequate oxygenation

4. Communication

   • Notify MD/RNP/PA of any changes in the patient's condition promptly

Rationale

1. Monitoring and Assessment

   • Regular monitoring of vital signs and cardiac symptoms allows for early detection and intervention of decreased cardiac output.
   • Identifying signs of decreased cardiac output helps prevent complications such as heart failure or shock.

2. Medication and Treatment

   • Administering prescribed medications helps manage the underlying conditions that may contribute to decreased cardiac output.
   • Monitoring lab results ensures that any imbalances or abnormalities are addressed promptly, supporting overall cardiac function.

3. Fluid and Oxygen Management

   • Following fluid restrictions helps prevent fluid overload, which can exacerbate cardiac issues.
   • Administering oxygen supports adequate tissue oxygenation, especially in cases of compromised cardiac output.

4. Communication

   • Prompt communication with the healthcare provider ensures timely adjustments to the care plan, preventing further complications.

Actions

1. Monitoring and Assessment

   • Record vital signs according to protocol, documenting any significant changes and reporting them immediately.
   • Observe for signs of decreased cardiac output, such as tachycardia, abnormal heart sounds, hypotension, decreased urine output, chest pain, weak peripheral pulses, pale or ashen skin, diaphoresis, orthopnea, and fatigue, and report findings to the healthcare provider.

2. Medication and Treatment

   • Administer cardiac medications (e.g., beta-blockers, ACE inhibitors, diuretics) as prescribed, monitoring for effectiveness and side effects.
   • Conduct and review lab tests as ordered, such as electrolytes, BUN/creatinine, and cardiac enzymes, reporting any abnormalities to the healthcare provider.

3. Fluid and Oxygen Management

   • Ensure adherence to fluid restrictions, educating the patient on the importance of limiting fluid intake.
   • Administer supplemental oxygen as prescribed, monitoring oxygen saturation levels and adjusting flow rates as needed to maintain adequate oxygenation.

4. Communication

   • Notify the MD/RNP/PA promptly of any changes in the patient's condition, including significant changes in vital signs, new or worsening symptoms, and lab abnormalities.
   • Document all communications with the healthcare provider and updates to the care plan.