EXPLANATION OF THE PROBLEM: Decreased Cardiac Output related to Decreased Ventricular Filling

With hypertension, or increased blood pressure, there is increased vascular resistance for blood to flow. Due to the patient’s diabetes mellitus, there is increased blood
viscosity, which leads to increased peripheral resistance and thus increased blood pressure. With the increase in blood pressure and decreased blood flow through all blood vessels,
there is decreased cardiac output or decreased output from the heart.
Assessment
S>
>”May hypertension ako”
>dizziness noted precipitated by exertion
>difficulty breathing and weakness noted
O>
>with IVF of PNSS 1li x SKVO
>with diabetes type 2
>with pale nail beds, palms, and soles
>capillary refill of 1 to 2 seconds
>with pulse rate of 89 characterized as
weak and thready pulse
>with blood pressure of 160/90mmHg
>GCS score of:
>drowsy
>patient is obese
>with postural instability when standing
>with bipedal edema noted
>diagnostics reveals metabolic acidosis
> (-) chest pain
Objectives Interventions Evaluation
Goal: Dx
The patient will be able to display  Assess mentation
hemodynamic stability such as having a  Assess heart rate and blood
blood pressure within normal limits. pressure
 Assess skin color and temp
LTO:  Assess peripheral pulses
After 3 days of nursing interventions, the  Assess fluid balance
patient will be able to display a decrease
 Review diagnostics result
in episodes of dyspnea and demonstrate an
increase in activity tolerance.  Note response to increased
activity
STO:  Assess for chest pain
After 45 minutes of nursing interventions, Tx
the patient will be able to participate in  Administer medication as
activities that reduce the workload of the prescribed
heart.  Restrict fluids and sodium ordered
 Place patient in semi to high
fowler’s position
 Maintain oxygen at 3LPM
Via nasal cannula
 Restrict activity provide quiet and
relaxed environment
 Cluster nursing and medical
activities
 Regulate IVF at SKVO as ordered
 Assisted on ADL’s
Ed
 Explain symptoms and
interventions for decreased
cardiac output
 Explain drug regimen, purpose,
dose, and side effects
 Explain progressive activities
schedule and signs of
overexertion
 Explain diet restrictions