Decreased Cardiac Output
Decreased Cardiac Output
The medical condition, decreased cardiac output, is the reduction in outflow of blood from the ventricles of the heart. There could be a variety of different reasons behind the decrease in the cardiac output.
Decreased Cardiac Output Causes:
The common causes/reasons behind this medical condition are hypertension, myocardial infarction, congenital heart disease, valvular heart disease, cardiac arrhythmias, pulmonary disease, cardiomyopathy, fluid overload, drug effects, electrolyte imbalance and decreased fluid volume. Geriatric patients are at a high risk of suffering from decrease cardiac output due to the reduced compliance of ventricles which results from aging.
Decreased Cardiac Output Symptoms:
The symptoms of this medical conditions could be electrocardiogram changes, arrhythimias, variations in haemodynamic parameters, tachypnea, orthopnea, dyspnea, frothy sputum, abnormal arterial blood gases, edema, weight gain, decreased urine output, dizziness, syncope, restlessness, anxiety, fatigue, weakness, cold clammy skin, decreased peripheral pulses, change in mental status, confusion, pulsus alternans, angina, etc. Decreased cardiac output and blood pressure are interrelated, since the decrease in cardiac output results into low blood pressure.
Home Care Interventions for Decreased Cardiac Output
- Begin discharge planning as soon as possible with case manager or social worker to assess home support systems and the need for community or home health services. These may be to assist with home care, assistance with meal perparations, housekeeping, personal care, transportation to doctor visits, or emotional support. Clients often need help upon discharge. The existing social support network needs to be assessed and assistance provided as needed to meet client needs and to keep the support persons from being overwhelmed. Being discharged to home without adequate support has been shown to be related to readmission of elderly patients.
- Assess or refer to case manager or social worker to evaluate client ability to pay for prescriptions. The cost of drugs may be a factor to fill prescriptions and adhere to a treatment plan.
- Continue to monitor client for exacerbation of heart failure when discharged home. Transition to home can create increased stress and physiological instability related to diagnosis.
- Assess client for understanding and compliance with medical regimen, including medications, activity level, and diet.
- Instruct family and client about the disease process, complications of disease process, information on medications, need for weighing daily, and when it is appropriate to call doctor. Early recognition of symptoms facilitates early problem solving and prompt treatment. Clients with heart failure need intensive guideline gased education about these topics to help prevent readmission to the hospital.
- Identify emergency plan, including use of CPR. Decreased cardiac output can be life threatening.
- Help family adapt daily living patterns to establish life changes that will maintain improved cardiac functioning in the client. Transition to the home setting can cause risk factors such as inappropriate diet to reemerge.
- Refer to physical therapy for strengthening exercises if client is not involved in cardiac rehabilitation.
- Refer to medical social services as necessary for counseling about the impact of severe or chronic cardiac disease. Social workers can assist the client and family with acceptance of life changes.