[solved]-Heart Failure Nursing Care Plans

In this nursing care plan guide are 15 NANDA nursing diagnosis for heart failure. Learn about the nursing interventions and assessment cues for heart failure including the goals, defining characteristics and related factors for each nursing diagnosis.
What is Heart Failure?

Heart failure (HF) or Congestive Heart Failure (CHF) is a physiologic state in which the heart cannot pump enough blood to meet the metabolic needs of the body.

Heart failure results from changes in the systolic or diastolic function of the left ventricle. The heart fails when, because of intrinsic disease or structural it cannot handle a normal blood volume or, in absence of disease, cannot tolerate a sudden expansion in blood volume. Heart failure isa progressive and chronic condition that is managed by significant lifestyle changes and adjunct medical therapy to improve quality of life. Heart failure is caused from a variety of cardiovascular conditions such as chronic hypertension, coronary artery disease, and valvular disease.

Heart failure is not a disease itself, instead, the term refers to a clinical syndrome characterized by manifestations of volume overload, inadequate tissue perfusion, and poor exercise tolerance. Whatever the cause, pump failure results in hypoperfusion of tissues, followed by pulmonary and systemic venous congestion.

Clinical Manifestations

The signs and symptoms of heart failure are defined based on which ventricle is affected — left-sided heart failure causes a different set of manifestations than right-sided heart failure.

Left-Sided Heart Failure

Dyspnea on exertion
Pulmonary congestion
Cough that is initially dry and nonproductive
Frothy sputum that is sometimes blood-tinged
Inadequate tissue perfusion
Weak, thready pulse
Fatigue

Right-Sided Heart Failure

Congestion of the viscera and peripheral tissues
Edema of the lower extremities

Because heart failure causes vascular congestion, it is often called congestive heart failure, although most cardiac specialist no longer uses this term. Other terms used to denote heart failure include chronic heart failure, cardiac decompensation, cardiac insufficiency, and ventricular failure.
Nursing Care Plans

Nursing care plan goals for patients with heart failure includes support to improve heart pump function by various nursing interventions, prevention, and identification of complications, and providing a teaching plan for lifestyle modifications. Nursing interventions include promoting activity and reducing fatigue to relieve the symptoms of fluid overload.

Here are 15 nursing care plans (NCP) and nursing diagnosis for patients with Heart Failure:

Decreased Cardiac Output
Activity Intolerance
Excess Fluid Volume
Risk for Impaired Gas Exchange
Risk for Impaired Skin Integrity
Deficient Knowledge
Acute Pain
Ineffective Tissue Perfusion
Hyperthermia
Ineffective Breathing Pattern
Ineffective Airway Clearance
Impaired Gas Exchange
Fatigue
Risk for Decreased Cardiac Output
Fear
Other Nursing Care Plans

Next
Decreased Cardiac Output

The heart fails to pump enough blood to meet the metabolic needs of the body. The blood flow that supplies the heart is also decreased therefore decrease in cardiac output occurs, blood then is insufficient and making it difficult to circulate the blood to all parts of the body thus may cause altered heart rate and rhythm, weakness and paleness.

Nursing Diagnosis

Decreased Cardiac Output: Inadequate blood pumped by the heart to meet metabolic demands of the body.

Related Factors

Altered myocardial contractility/inotropic changes
Alterations in rate, rhythm, electrical conduction
Structural changes (e.g., valvular defects, ventricular aneurysm)
Poor cardiac reserve
Side effects of medication
Generalized weakness.

Defining Characteristics

Increased heart rate (tachycardia), dysrhythmias, ECG changes
Changes in BP (hypotension/hypertension)
Extra heart sounds (S3, S4)
Decreased urine output
Diminished peripheral pulses
Cool, ashen skin; diaphoresis
Orthopnea, crackles, JVD, liver engorgement, edema
Chest pain

Desired Outcomes

Patient will demonstrate adequate cardiac output as evidenced by vital signs within acceptable limits, dysrhythmias absent/controlled, and no symptoms of failure (e.g., hemodynamic parameters within acceptable limits, urinary output adequate).
Patient will report decreased episodes of dyspnea, angina.
Patient will participate in activities that reduce cardiac workload.

Expert Answer

---

. . .