Question

What is a nursing diagnosis (related to and evidenced by) and long term goal for decreased cardiac output and deficient knowledge?

The patient is a 60-year-old male who has hypertension and heart failure. He had Hydrochlorothiazide prescribed by MD for his hypertension a couple of years ago. However, the patient has not taken the medications as directed. He complains that he is experiencing increasing fatigue, shortness of breath, paroxysmal nocturnal dyspnea and weight gain. An ECG and a chest x-ray were performed and also had blood drawn. The patient is alert and oriented. His bp was 168/96 mmHg, the temperature was 98.4, pulse 98/min and RR was 22/min. Oxygen saturation 90% on room air and increased to 94% with oxygen at 2 liters/min, per nasal cannula. The nurse administered Enalapril 5 mg PO.

Answer 1

decreased cardiac output and deficient knoledge:
Nursing diagnosis:
-risk for excess fluid volume due to reduced GFR and sodium and water retention
-anxiety due to disease progress and breathlessness, fatigue, and weight gain
-Deficient knowledge due to poor understanding of cardiac function and disease.
-Risk for an impaired gas exchange due to fluid collection and shift of fluid into alveoli and interstitial space
-Ineffective airway clearance due to increased secretion in the lungs.
-fatigue due to decreased metabolic demands of the body.
Long term goal:
patient demonstrates adequate ventilation on ABG and pulse oximetry and there are no symptoms of dyspnea and shortness of breath.
Patient able to establish and maintain clear airway patency.
the patient has more energy
patient having normal breath sounds and lung is clear and improvement in gas exchange.
Patient explains treatment and intervention plan and prevention of complications, the patient can identify signs and symptoms of decreased cardiac function, the patient changed his lifestyle behavior.
the patient understands the fluid and diet restrictions, weight management, and lung clearance, balancing intake and output.
patient cardiac output is normal with normal blood pressure, able to perform his normal activity.
the patient tells about the precautions and care to avoid side effects, risk, and complications due to cardiac disease.
patient adherence to his cardiac medications.