Decreased Cardiac Output: Clinical Validation in Patients With Decompensated Heart Failure

PURPOSE:  Clinically validate (using Fehring's model) characteristics of the nursing diagnosis (ND) of decreased cardiac output (DCO) in 29 patients with decompensated heart failure. METHODS:  Cross-sectional study conducted in a Brazilian university hospital. FINDINGS:  According to the reliability rate (R) between the experts, the major characteristics (R ≥ 0.80) were fatigue, dyspnea, edema, orthopnea, paroxysmal nocturnal dyspnea, and elevated central venous pressure, and the secondary characteristics were weight gain, hepatomegaly, jugular vein distension, palpitations, crackles, oliguria, coughing, clammy skin, and skin color changes. CONCLUSION:  Characteristics with R > 0.50 and ≤1 were valid in the ND of DCO. Implications for the nursing practice: Clinical validation studies are necessary to determine the adequacy of this diagnosis and its determining characteristics with Taxonomy II. OBJETIVO:  Validar clinicamente, segundo o modelo proposto por Fehring, as caracteristicas definidoras do diagnostico de enfermagem (DE) debito cardiaco diminuido (DCD) em 29 pacientes com insuficiencia cardiaca congestiva descompensada. METODOS:  Estudo transversal conduzido em um hospital universitario no sul do Brazil. RESULTADOS:  De acordo com a taxa de fidedignidade de Fehring (R) obtidas entre as peritas, as caracteristicas definidoras consideradas maiores (R ≥ 0.80) foram fadiga, dispneia, edema, ortopneia, dispneia paroxistica noturna e pressao venosa central aumentada; e caracteristicas secundarias foram ganho de peso, hepatomegalia, distensao da veia jugular, palpitacoes, crepitacoes, oliguria, tosse, pele fria e pegajosa e mudancas na cor da pele. CONCLUSAO:  Caracteristicas com R > 0.50 e ≤1 foram validadas para o diagnostico debito cardiaco diminuido (DCD). IMPLICACOES PARA PRATICA DE ENFERMAGEM:  Estudos de validacao clinica sao necessarios para evidenciar a adequacao deste diagnostico e suas caracteristicas definidoras a Taxonomia II.