Altered hemodynamic status refers to changes in blood flow dynamics that can compromise cardiovascular function and tissue perfusion. This nursing diagnosis focuses on identifying and managing changes in blood flow, preventing complications, and optimizing cardiovascular function.
Causes (Related to)
Altered hemodynamic status can result from various factors affecting cardiovascular function:
- Cardiovascular conditions:
- Heart failure
- Myocardial infarction
- Cardiac arrhythmias
- Valvular heart disease
- Hypertension
- Shock states
- Systemic conditions:
- Sepsis
- Severe dehydration
- Blood loss
- Severe infections
- Endocrine disorders
- Medications and treatments:
- Antihypertensive medications
- Diuretics
- Vasodilators
- Mechanical ventilation
- Anesthesia
Signs and Symptoms (As evidenced by)
Altered hemodynamic status presents with various signs and symptoms that nurses must monitor closely.
Subjective: (Patient reports)
- Dizziness or lightheadedness
- Chest pain or discomfort
- Shortness of breath
- Fatigue
- Palpitations
- Anxiety
- Weakness
Objective: (Nurse assesses)
- Abnormal blood pressure (high or low)
- Irregular heart rate or rhythm
- Changes in cardiac output
- Abnormal heart sounds
- Decreased peripheral perfusion
- Changes in mental status
- Decreased urine output
- Edema
- Abnormal cardiac markers
Expected Outcomes
The following outcomes indicate successful management of altered hemodynamic status:
- The patient will maintain stable vital signs within the target range
- The patient will demonstrate improved tissue perfusion
- The patient will maintain adequate cardiac output
- The patient will report decreased symptoms
- The patient will demonstrate improved exercise tolerance
- The patient will maintain optimal fluid balance
- The patient will avoid complications
Nursing Assessment
Monitor Cardiovascular Status
- Assess vital signs frequently
- Monitor cardiac rhythm
- Check peripheral pulses
- Evaluate capillary refill
- Assess heart sounds
- Monitor hemodynamic parameters
Evaluate Tissue Perfusion
- Check skin color and temperature
- Monitor mental status
- Assess urine output
- Evaluate peripheral edema
- Check for delayed capillary refill
Assess Fluid Status
- Monitor intake and output
- Check weight changes
- Assess skin turgor
- Evaluate jugular venous distension
- Monitor lab values
Monitor for Complications
- Watch for signs of shock
- Assess for organ dysfunction
- Monitor for dysrhythmias
- Check for signs of heart failure
- Evaluate for thromboembolic events
Review Risk Factors
- Assess cardiac history
- Review medications
- Check for comorbidities
- Evaluate lifestyle factors
- Monitor laboratory values
Nursing Care Plans
Nursing Care Plan 1: Decreased Cardiac Output
Nursing Diagnosis Statement:
Decreased Cardiac Output related to altered contractility and preload/afterload changes as evidenced by decreased blood pressure, tachycardia, and poor peripheral perfusion.
Related Factors:
- Altered contractility
- Changes in preload/afterload
- Dysrhythmias
- Fluid volume alterations
Nursing Interventions and Rationales:
- Monitor vital signs and hemodynamic parameters q2h
Rationale: Early detection of cardiovascular compromise - Assess peripheral perfusion
Rationale: Indicates adequacy of tissue perfusion - Administer prescribed medications
Rationale: Optimizes cardiac function
Desired Outcomes:
- The patient will maintain stable cardiac output
- The patient will demonstrate improved tissue perfusion
- The patient will maintain stable vital signs
Nursing Care Plan 2: Risk for Decreased Tissue Perfusion
Nursing Diagnosis Statement:
Risk for Decreased Tissue Perfusion related to altered blood flow and cardiovascular compromise as evidenced by poor peripheral perfusion and altered vital signs.
Related Factors:
- Altered blood flow
- Cardiovascular dysfunction
- Fluid volume changes
- Vasoactive medication effects
Nursing Interventions and Rationales:
- Monitor peripheral circulation q2h
Rationale: Detects early signs of tissue hypoperfusion - Position patient to optimize blood flow
Rationale: Improves tissue perfusion - Maintain optimal fluid balance
Rationale: Ensures adequate circulation
Desired Outcomes:
- The patient will maintain adequate tissue perfusion
- The patient will demonstrate improved peripheral circulation
- The patient will maintain optimal fluid balance
Nursing Care Plan 3: Impaired Gas Exchange
Nursing Diagnosis Statement:
Impaired Gas Exchange related to altered hemodynamic status as evidenced by dyspnea and decreased oxygen saturation.
Related Factors:
- Ventilation-perfusion mismatch
- Altered cardiac output
- Pulmonary congestion
- Tissue hypoxia
Nursing Interventions and Rationales:
- Monitor oxygen saturation continuously
Rationale: Ensures adequate oxygenation - Position for optimal breathing
Rationale: Improves ventilation-perfusion matching - Administer oxygen as prescribed
Rationale: Maintains adequate tissue oxygenation
Desired Outcomes:
- The patient will maintain oxygen saturation >95%
- The patient will demonstrate improved gas exchange
- The patient will report decreased dyspnea
Nursing Care Plan 4: Anxiety
Nursing Diagnosis Statement:
Anxiety related to altered cardiovascular function as evidenced by expressed concerns and increased vital signs.
Related Factors:
- Physical symptoms
- Fear of complications
- Uncertainty about prognosis
- Limited understanding of the condition
Nursing Interventions and Rationales:
- Provide clear explanations
Rationale: Reduces anxiety through understanding - Teach relaxation techniques
Rationale: Helps manage anxiety symptoms - Monitor anxiety’s effect on hemodynamics
Rationale: Prevents further cardiovascular compromise
Desired Outcomes:
- The patient will demonstrate reduced anxiety
- The patient will use effective coping strategies
- The patient will maintain stable vital signs during stress
Nursing Care Plan 5: Risk for Falls
Nursing Diagnosis Statement:
Risk for Falls related to hemodynamic instability as evidenced by orthostatic hypotension and dizziness.
Related Factors:
- Orthostatic hypotension
- Medication effects
- Altered mental status
- Physical weakness
Nursing Interventions and Rationales:
- Implement fall precautions
Rationale: Prevents injury from falls - Assist with mobilization
Rationale: Ensures safe movement - Monitor orthostatic blood pressure
Rationale: Identifies risk for postural hypotension
Desired Outcomes:
- The patient will remain free from falls
- The patient will demonstrate safe mobility
- The patient will maintain stable blood pressure with position changes
References
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