D.0008
Penurunan Curah Jantung
Kategori : Subkategori
Fisiologis : Sirkulasi
Definisi
Ketidakadekuatan jantung memompa darah untuk memenuhi kebutuhan metabolisme tubuh.
Penyebab
1. Perubahan irama jantung
2 Perubahan frekuensi jantung
3. Perubahan kontraktilitas
4. Perubahan preload
5 Perubahan afterload
Gejala dan Tanda Mayor
Subjektif
1. Perubahan irama jantung
1) Palpitasi
2 Perubahan preload
1)
Lelah
3. Perubahan afterload
1)
Dispnea
4. Perubahan kontraktilitas
1) Paroxysmal nocturnal dyspnea (PND)
2) Ortopnea
3) Batuk
Objektif
1)
Bradikardia/takikardia
2) Gambaran EKG aritmia atau gangguan konduksi
2. Perubahan preload
1) Edema
2) Distensi vena jugularis
3) Central venous pressure(CVP)
meningkat/menurun
4) Hepatomegali
3. Perubahan afterload
1) Tekanan darahmeningkat/menurun
2) Nadi perifer teraba lemah
3) Capillary refill time >3 detik
4) Oliguria
5) Warna kulit pucat dan/atau sianosis
1) Terdengar suara jantung s3 dan/atau S4
2) Ejection fraction (EF)menurun
Gejala dan Tanda Minor
Subjektif
1. Perubahan preload (tidak tersedia)
2. Perubahan afterload (tidak tersedia)
3. Perubahan kontraktilitas (tidak tersedia)
4. Perilaku/emosional
1) Cemas
2) Gelisah
Objektif
1. Perubahan preload
1) Murmur jantung
2) Berat badan bertambah
3) Pulmonary artery wedge pressure (PAWP) menurun
2. Perubahan afterload
1) Pulmonary vascular resistance
(PVR)meningkat/menurun
2) Systemic vascular resitance (SVR) meningkat/menurun
3. Perubahan kontraktilitas
1) Cardiac index (CI)menurun
2) Left ventricular stroke work index (LVSWI)
menurun
3) Stroke volume index (SVI)menurun
4. Perilaku/emosional (tidak tersedia)
Kondisi Klinis Terkait
1 Gagal jantung kongestif
2. Sindrom koroner akut
3. Stenosis mitral
4. Regurgitasi
mitral
5. Stenosis aorta
6. Regurgitasi aorta
7. Stenosis trikuspidal
8 Regurgitasi trikuspidal
9 Stenosis pulmonal
10 Regurgitasi pulmonal
11. Aritmia
12. Penyakit jantung bawaan
Referensi
Ackley, B. J., Ladwig, G. B., & Makic, M.
B. F. (2017). Nursing Diagnosis Handbook An Evidence-Based Guide to Planning
Care. 11" Ed. St. Louis: Elsevier
Brandão, S. G., Altino, D. M. Silva, R. e.,
& Lopes, J. L. (2011). Defining Characteristics of Decreased Cardiac Output
A Literature ReviewInternational Journal Of Nursing Terminologies &
Classifications, 22(2), 92-102. doi:10.11114 1744-618X 2010.01174.x.
Cameiro, C. S., Lopes, J. L, Herdman, T. H.,
Lopes, C. T., Bachion, M. M., & Bottura Lete de Barros, A. L. (2014).
Construction and Validation of a Data Collection Tool for the Clinical
Assessment of Human Responses of Outpatients With Chronic Cardiovascular
Diseases. International Joumal Of Nursing Knowledge, 25(3), 161-167. doi:
10.1111/2047-3095.12029.
Carperito-Moyet, L. J. (2013). Nursing
Diagnosis Application to Clinical Practice. 14"Ed. Philadelphia:
Lippincott Williams & Wilkins.
de Souza, V. Zeitoun, S. S., Lopes, C. T., de
Oliveira, A. D., Lopes, J. L, & de Barros, AL (2015) Clinical usefulness of
the definitions for defining characteristics of activity intolerance, excess
fluid volume and decreased cardiac output in decompensated heart failure: a
descriptive exploratory study Joumal Of Clinical Nursing, 24(17-18),
2478-2487.doi: 10.1111/joon 12832
Doenges, M. E., Moorhouse, M. F., & Mur,
A. C. (2013). Nursing Diagnosis Manual Planning Individualizing and Documenting
Client Care. 4 Ed. Philadelphia: F. A. Davis Company.
Hardman, T. H. & Kamitsuru, 5 (2014).
Nursing Diagnosis Definitions and Classification 2015-2017. 10 Ed. Oxford:
Wiley Blackwell. Martins, Q. S., All, G. & Rabelo, E R. (2010) Decreased
Cardiac Output: Clinical Validation in Patients With Decompensated Heart
Failure International Journal of Nursing Terminologies and Classifications,
21(4) httpidol.org/10.111141744-618x 2010.01161
Rojas Sánchez. LZ, Hemández Vargas, J. A.,
Trujillo Cáceres, S. J., Ros Díaz, Z.M. Jurado Arenales, A. M., & Tolaza
Pérez, Y. G. (2016). Usefulness of the Diagnosis "Decreased Cardiac Output
(00029) in Patients With Chronic Heart Failure. International Journal Of
Nursing Knowledge, doi:10.1111/2047-3095 12148
Sumana, H. (2010) Handbook for medical-surgical nursing Philadelphia: Wolters Kluwer Health
