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    NCP - Decreased Cardiac Output

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    Izza Deloria
    L.N. is a 49-year-old woman with type 2 diabetes, obesity, hypertension, and migraines who presents with headache and neck pain. She has a blood pressure of 154/86 mmHg. The nurse assessed L.N. and diagnosed her with decreased cardiac output related to increased vascular vasoconstriction, as evidenced by her elevated blood pressure. The nurse's plan is to monitor L.N.'s vital signs, keep her on bed rest, and provide health teachings to help lower her blood pressure and relieve her symptoms within 4 hours.

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    NCP - Decreased Cardiac Output

    Uploaded by

    Izza Deloria
    179 views3 pages
    L.N. is a 49-year-old woman with type 2 diabetes, obesity, hypertension, and migraines who presents with headache and neck pain. She has a blood pressure of 154/86 mmHg. The nurse assessed L.N. and diagnosed her with decreased cardiac output related to increased vascular vasoconstriction, as evidenced by her elevated blood pressure. The nurse's plan is to monitor L.N.'s vital signs, keep her on bed rest, and provide health teachings to help lower her blood pressure and relieve her symptoms within 4 hours.

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    L.N. is a 49-year-old woman with type 2 diabetes, obesity, hypertension, and migraines who presents with headache and neck pain. She has a blood pressure of 154/86 mmHg. The nurse assessed L.N. and diagnosed her with decreased cardiac output related to increased vascular vasoconstriction, as evidenced by her elevated blood pressure. The nurse's plan is to monitor L.N.'s vital signs, keep her on bed rest, and provide health teachings to help lower her blood pressure and relieve her symptoms within 4 hours.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    179 views3 pages

    NCP - Decreased Cardiac Output

    Uploaded by

    Izza Deloria
    L.N. is a 49-year-old woman with type 2 diabetes, obesity, hypertension, and migraines who presents with headache and neck pain. She has a blood pressure of 154/86 mmHg. The nurse assessed L.N. and diagnosed her with decreased cardiac output related to increased vascular vasoconstriction, as evidenced by her elevated blood pressure. The nurse's plan is to monitor L.N.'s vital signs, keep her on bed rest, and provide health teachings to help lower her blood pressure and relieve her symptoms within 4 hours.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    Case:

    L.N. is a 49-year-old white woman with a history of type 2 diabetes, obesity, hypertension, and migraine
    headaches. The patient was diagnosed with type 2 diabetes 9 years ago when she presented with mild polyuria and
    polydipsia. L.N. is 5′4″ and has always been on the large side, with her weight fluctuating between 165 and 185 lb.

    Initial treatment for her diabetes consisted of an oral sulfonylurea with the rapid addition of metformin. Her diabetes
    has been under fair control with a most recent hemoglobin A1c of 7.4%.

    Hypertension was diagnosed 5 years ago when blood pressure (BP) measured in the office was noted to be
    consistently elevated in the range of 160/90 mmHg on three occasions. L.N. was initially treated with lisinopril, starting at
    10 mg daily and increasing to 20 mg daily, yet her BP control has fluctuated.

    One year ago, microalbuminuria was detected on an annual urine screen, with 1,943 mg/dl of microalbumin
    identified on a spot urine sample. L.N. comes into the office today for her usual follow-up visit for diabetes. Physical
    examination reveals an obese woman with a BP of 154/86 mmHg and a pulse of 78 bpm. She is complaining with nape
    pain and headache.
    ASSESSMENT NURSING DIAGNOSIS PLANNING INTERVENTIONS EVALUATION
    Subjective: Decreased cardiac Within 4 hours of 1.) Checked laboratory data (cardiac GOAL MET
    -Complains output r/t increased nursing interventions, markers, complete blood cell count,
    headache and vascular the patient will be electrolytes, ABGs, blood urea
    pain in the nape vasoconstriction as able to: nitrogen and creatinine, cardiac
    evidenced by a blood 1) establish blood enzymes, and cultures).
    Objective: pressure of 154/86 pressure R: This is done to identify contributing
    -Diagnosed with mmHg within normal factors and promote early
    type 2 diabetes, Rationale: range (120/80 intervention, if indicated.
    when she Decreased cardiac mmHg-90/60
    presented with output is the inadequate mmHg); 2.) Monitored patient’s vital signs
    mild polyuria pumping of blood by the 2) report relief periodically. Blood pressure was
    and polydipsia heart to meet the from headache measured in both arms three times,
    -Diagnosed with metabolic demands of and pain in the three to five minutes apart while the
    hypertension the body (Doenges, nape; and patient was at rest.
    when blood Moorhouse, & Murr, 3) verbalize R: This is done to know the patient’s
    pressure was 2016). The constriction understanding response to activities and
    noted to be of arterioles increases of health interventions.
    consistently resistance, which teachings.
    elevated in the causes a decrease in 3.) Kept patient on bed rest in a
    range of 160/90 blood flow to Semi-Fowler’s position.
    mmHg on three downstream capillaries R: This position decreases oxygen
    occasions and a larger decrease in consumption and the risk of
    -Detected with blood pressure decompensation.
    microalbuminuri (Chaudhry, Miao, &
    a with 1,943 Rehman, 2020). 4.) Noted presence, quality of central
    mg/dl of Source: and peripheral pulses.
    microalbumin Chaudhry, R., Miao, J., R: Bounding carotid, jugular, radial,
    identified on a & Rehman, A. (2020). and femoral pulses may be observed
    spot urine Physiology, and palpated. Pulses in the legs and
    sample Cardiovascular. feet may be diminished, reflecting
    -Vital signs: Retrieved on July 1, effects of vasoconstriction (increased
    BP – 154/86 2020 from systemic vascular resistance) and
    mmHg https://www.ncbi.nlm.nih venous congestion.
    -Obese .gov/books/NBK493197/
    Doenges, M., 5.) Observed skin color, moisture,
    Moorhouse, M., & Murr, temperature, and capillary refill time.
    A. (2016). Nurse’s R: Presence of pallor; cool, moist
    Pocket Guide: skin; and delayed capillary refill time
    Diagnoses, Prioritized may be due to peripheral
    Interventions, and vasoconstriction or reflect cardiac
    Rationales (14th ed.). decompensation and decreased
    Philadelphia: F.A. Davis output.
    Company.

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