need help with NANDA decreased CO r/t altered heart rhythm

[sillygurl, ADN, BSN, MSN, RN]

Hi, I need help please - I can't figure out what to use as my AEB because I need to tailor my interventions to them.

Pt. is a 75 y.o. male dx with aortic dissection type B. Hx of a-fib x17years, chf, htn with poor control. When I was caring for him, he was waiting for surgery two days later and was very anxious but my care plan needs to be cardiac related.

Assessment: bilateral lower extremities with 1+ edema, c/o dyspnea, pulses 2+ radial and pedal, RBC 3.92 (L) hgb 12.2 (L), hct 37.3 (L), bnp 293 (H), bun 31(H), ca 7.9 (L)

treatment: FIO2 @ 2L, Nicardipine, esmolol,bumetanide, sodium bicarb drip.

thank you!

[Nurse Kyles, BSN, RN]

Can you put something like:

Decreased cardiac output r/t impaired cardiac function AEB: (specific heart rhythm), BNP: 239, etc.

Good Luck!

[tarheelsu]

I would think you could use the +1 edema as part of your AEB.

Was he on tele? If so do you have his rhythm from that. Did he have any abnormal heart sounds? What was his rate and rhythm? What were his other VS?

[CCL RN, RN]

Decreased CO R/T altered heart rhythm (a-fib) AEB dyspnea, +1 edema in bilateral lower extremity,and elevated BNP.

[CCL RN, RN]

Can you put something like:

Decreased cardiac output r/t impaired cardiac function AEB: (specific heart rhythm), BNP: 239, etc.

Good Luck!

The AEB must be the signs and symptoms that are showing or 'proving' your nursing Dx. A-fib doesn't always cause decreased CO. A s/s of decreased CO is the edema, dyspnea, and BNP elevation.