How to measure cardiac contractility and stroke volume??

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Hi,

I am helping my classmate with her graded care plan for "risk for decreased cardiac output r/t altered contractility and altered stroke volume 2nd to CABG

Because it is her graded care plan, our instructor is not allow to give her much feedback. When emailing the instructor to see if her nanda is correct, she answered that she is on the right track but then ask her the following. And this is where I need help!!

How we measure contractility and stroke volume on a pt on a tele floor?

From what we learned in class, the only way to measure the stroke volume, for example, is by using a PA cath. Is there any other way?

The teacher told her that she need to know that and that needs to be added to her care plan.

I appreciate your help!!!

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Have your friend join AN! We will be happy to help her as well! as always we are happy to help but we need to know what they think first so I know how to best help them understand....:).

How would you measure/assess that the heart is working and working well.....

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Or an Echo to measure EF

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Esme12, I've told her to sign up but she is not too good with computers. So I am trying to help her out. Our understanding is that we could only get those measurements using the PA cath. The way that our instructor sound, it felt that it was something that we could do on the floor.

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Specializes in Emergency, Telemetry, Transplant.

Basically the only way you will get a real time CO number is with a PA cath. On a telemetry floor that is not an option. So, as Esme was saying, how are you able to tell that the heart is doing an adequate (or inadequate job) of pumping blood through the body? Hint: look though the physical assessment. What data gives you an idea of how well the heart is working?

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Your friend needs to get better with computers as she will be dealing with them every day at work.

When you are caring for a patient.....what would indicate to you that the heart isn't functioning properly. Think Signs and symptoms/physical assessment. What are the indicators of end organ perfusion?

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Specializes in ER, progressive care.

CO = HR x SV, and there are three determinants of SV. What are they? ;)

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There are 4 dereminants CO.. and there is now a device called a NICOM..it non invasive cardiac output monitor..its very cool..seen it used in SICU

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I knew about S&S so I guess my thought was right. I just wasn't sure if there was another "tool" that we could use. Thank you so much for your help. You guys are always so helpful!!

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You may need to rely on the last cardiac cath data, as all of those parameters would have been measured there. If the patient was previously in the CVICU, CCU, or even a stepdown unit, s/he might have had a Swan-Ganz in place to measure CO, from which you derive SV.

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