13 Heart Failure Nursing Care Plans

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In this nursing care plan guide are 13 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.

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 perfusioon
  • 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 13 nursing care plans (NCP) and nursing diagnosis for patients with Heart Failure:

  1. Decreased Cardiac Output
  2. Activity Intolerance
  3. Excess Fluid Volume
  4. Risk for Impaired Gas Exchange
  5. Risk for Impaired Skin Integrity
  6. Deficient Knowledge
  7. Acute Pain
  8. Ineffective Tissue Perfusion
  9. Hyperthermia
  10. Ineffective Breathing Pattern
  11. Ineffective Airway Clearance
  12. Impaired Gas Exchange
  13. Fatigue
  14. Other Nursing Care Plans
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Fatigue

Fatigue: An overwhelming, sustained sense of exhaustion and decreased capacity for physical and mental work at usual level.

Heart failure is a physiologic state in which the heart cannot pump enough blood to meet the metabolic demands of the body. Since the patient has inadequate cardiac output, it can lead to hypoxic tissue and slowed removal of metabolic wastes, which in turn cause the patient to tire easily.

Assessment

Patient may manifest:

  • Weakness
  • Limited range of motion

Diagnosis

  • Fatigue

Planning & Desired Outcomes

  • Patient will report improved sense of energy

Nursing Interventions

Nursing InterventionsRationale
Nursing Assessment
Review medication regimen.Certain medications are known to cause or exacerbate fatigue.
Assess vital signs.To evaluate fluid status and cardiopulmonary response to activity.
Determine presence or degree of sleep disturbances.Fatigue can be a consequence of sleep deprivation.
Obtain client descriptions of fatigue.To assist in evaluating impact on client’s life.
Ask client to rate fatigue.To determine degree of fatigability.
Therapeutic Interventions
Note daily energy patterns.Helpful in determining pattern or timing of activity.
Establish realistic activity goals with client and encourage forward movement.Enhances commitment to promoting optimal outcomes.
Plan interventions to allow individually adequate rest periods.To maximize participation.
Assist with self-care needs and ambulation.To conserve energy for other tasks.
Avoid exposure to temperature and humidity extremesHas negative impact on energy level.
Instruct client in ways to monitor responses to activity and significant signs or symptoms.Indicate the need to alter activity level
Promote overall health measuresTo promote energy
Provide supplemental oxygen, as indicated.Presence of hypoxemia reduces oxygen available for cellular uptakes and contributes to fatigue.
Assist client to identify appropriate coping behaviors.Promote sense of control and improves self-esteem.
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References and Sources

Recommended references and sources for heart failure nursing care plan:

  • Black, J. M., & Hawks, J. H. (2009). Medical-surgical nursing: Clinical management for positive outcomes (Vol. 1). A. M. Keene (Ed.). Saunders Elsevier. [Link]
  • Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nurse’s pocket guide: Diagnoses, prioritized interventions, and rationales. FA Davis. [Link]
  • Gulanick, M., & Myers, J. L. (2016). Nursing Care Plans: Diagnoses, Interventions, and Outcomes. Elsevier Health Sciences. [Link]
  • Jaarsma, T., Strömberg, A., De Geest, S., Fridlund, B., Heikkila, J., Mårtensson, J., … & Thompson, D. R. (2006). Heart failure management programmes in Europe. European Journal of Cardiovascular Nursing5(3), 197-205. [Link]
  • Scott, L. D., Setter-Kline, K., & Britton, A. S. (2004). The effects of nursing interventions to enhance mental health and quality of life among individuals with heart failure. Applied Nursing Research17(4), 248-256. [Link]

See Also

You may also like the following posts and care plans:

Cardiac Care Plans


Nursing care plans about the different diseases of the cardiovascular system:

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