Dx Cardiac Output - these crazy NANDA's!!

Wave Watcher · Nov 19, 2011

I'm assuming you mean HGB not HBG?

I am not aware of low hemoglobin being evidence of decreased cardiac output.

Someone please correct me if I am wrong. It's been awhile since I have worked with cardiac patients.

Esme12, ASN, BSN, RN · Nov 19, 2011

cardiac output, - is the total volume of blood pumped by the ventricle per minute, or simply the product of heart rate (hr) and stroke volume (sv). the stroke volume at rest in the standing position averages between 60 and 80 ml of blood in most adults. thus at a resting heart rate of 80 beats per minute the resting cardiac output will vary between 4.8 and 6.4 l per min. however, the cardiac output of olympic medal winners in cross country skiing increased 8 times above resting cardiac output to approximately 40 liters for one minute of maximal work with an accompanied stroke volume of 210 ml per beat.

the average adult body contains about 5 l of blood, so this means all of our blood is pumped through our hearts about once every minute....so if there is less volume would it affect the output???

cardiac output = heart rate x stroke volume (co = hr x sv)

changes in either heart rate or stroke volume will have an impact on the other component

http://skillstat.com/pdf/mceco.pdf

http://www.cvphysiology.com/cardiac%20function/cf001.htm

and hypovolemia http://intensivecareunit.wordpress.com/category/hemorrhage-and-hypovolemia/

care plan basics:

every single nursing diagnosis has its own set of symptoms, or defining characteristics. they are listed in the nanda taxonomy and in many of the current nursing care plan books that are currently on the market that include nursing diagnosis information. you need to have access to these books when you are working on care plans. there are currently 188 nursing diagnoses that nanda has defined and given related factors and defining characteristics for. what you need to do is get this information to help you in writing care plans so you diagnose your patients correctly.

don't focus your efforts on the nursing diagnoses when you should be focusing on the assessment and the patients abnormal data that you collected. these will become their symptoms, or what nanda calls defining characteristics.

how does a doctor diagnose? he/she does (hopefully) a thorough medical history and physical examination first. surprise! we do that too! it's part of step #1 of the nursing process. only then, does he use "medical decision making" to ferret out the symptoms the patient is having and determine which medical diagnosis applies in that particular case. each medical diagnosis has a defined list of symptoms that the patient's illness must match. another surprise! we do that too! we call it "critical thinking and it's part of step #2 of the nursing process. the nanda taxonomy lists the symptoms that go with each nursing diagnosis.

here are the steps of the nursing process and what you should be doing in each step when you are doing a written care plan:

assessment (collect data from medical record, do a physical assessment of the patient, assess adl's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
determination of the patient's problem(s)/nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use)
planning (write measurable goals/outcomes and nursing interventions)
implementation (initiate the care plan)
evaluation (determine if goals/outcomes have been met)

now, listen up, because what i am telling you next is very important information and is probably going to change your whole attitude about care plans and the nursing process. . .a care plan is nothing more than the written documentation of the nursing process you use to solve one or more of a patient's nursing problems. the nursing process itself is a problem solving method that was extrapolated from the scientific method used by the various science disciplines in proving or disproving theories.

https://allnurses.com/general-nursing-student/help-care-plans-286986.html

http://wps.prenhall.com/chet_perrin_criticalcare_1/98/25166/6442619.cw/index.html

http://www.pterrywave.com/nursing/care%20plans/nursing%20care%20plans%20toc.aspx

http://www.csufresno.edu/nursingstudents/fsnc/nursingcareplans.htm

nurseprnRN, BSN, RN · Nov 21, 2011

now that you know that cardiac output is, well, the amount of blood a heart puts out (usually measured in liters per minute, also by stroke volume, which is the volume of blood pumped in one ventricular contraction) you should be able to get some better ideas of how a low one would affect someone.

again, do not think that because there is a medical diagnosis that there is an attached magic list of nursing diagnoses out there in a one from column a, one from column b relationship.

there is nothing crazy about nursing diagnosis and plan of care, any more than there is something crazy about medical diagnosis and plan of care. nursing diagnoses come from nursing assessments. some of the nursing assessment will include information that is used to make medical diagnoses, too, but nursing dx is not subject to, a subset of, or a poor stepchild of the medical dx.

reread in your nanda book to see what kinds of nursing diagnoses can result from low cardiac output, and you will be on your way to completing this assignment. if you have questions over something that confuses you, ask.

ImThatGuy, BSN, RN · Nov 26, 2011

I'm working on nursing dx for dec. cardiac output. Are decreased HBG and HCT evidence of ded. cardiac output?

In a word, no.

bols27 · Nov 28, 2011

I think there are some crazy nursing diagnoses...one of which being "disturbed energy field"... i mean come on. someone had to be laughing when they wrote that one, or "impaired religiosity" rip me apart all you want but these just sound silly.

Esme12, ASN, BSN, RN · Nov 28, 2011

I think there are some crazy nursing diagnoses...one of which being "disturbed energy field"... i mean come on. someone had to be laughing when they wrote that one, or "impaired religiosity" rip me apart all you want but these just sound silly.

:uhoh3: :uhoh3: No ripping here......what crack smoking over educated idiot thought of these???? :uhoh3: :uhoh3:

nurseprnRN, BSN, RN · Nov 28, 2011

let us not throw the baby out c the bathwater. remember that medical authorities once considered the uterus and privy parts the main source of neurosis in women, and that bumps on the skull indicated strength/weakness in the underlying brain structure, thus accounting for personality, criminality, genius, and other things. doesn't mean that all of gynecology and neuropsychiatry is useless.

(yeah, i think "disturbed energy field" is a crock, too. don't just sit there, send nanda a letter. they do remove diagnoses from time to time, and i think this one's time has come!)

Esme12, ASN, BSN, RN · Nov 28, 2011

let us not throw the baby out c the bathwater. remember that medical authorities once considered the uterus and privy parts the main source of neurosis in women, and that bumps on the skull indicated strength/weakness in the underlying brain structure, thus accounting for personality, criminality, genius, and other things. doesn't mean that all of gynecology and neuropsychiatry is useless.
(yeah, i think "disturbed energy field" is a crock, too. don't just sit there, send nanda a letter. they do remove diagnoses from time to time, and i think this one's time has come!)

i agree but i have to say, if i was sitting in post conference and someone told me to add "disturbved energy field" on a care plan i would not be able to help myself and bust out laughing. i am not against nanda and i actually think the care plans (though the most hated task on earth) help develop those thinking skills that nurses need to organize care. i like to compare a care plan to the grocery list so you can get in, get what you need and get out without forgetting anything, or directions to somewhere so you don't get lost. impaired religiousity? i get it but at some point it's just too, too, much to hear.

but insinuating that the author's were under the influence was harsh.........at risk for impaired intellect is probably a kinder way of wording my sediments. (wink,wink).....