15 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:

  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. Risk for Decreased Cardiac Output
  15. Fear
  16. Other Nursing Care Plans


Fear: Response to perceived threat that is consciously recognized as a danger.

Heart failure is a chronic condition that patient may experience a sense of fear with regards of the symptoms, treatment modalities and prognosis of the disease.


  • Anticipation of pain
  • Anticipation or perceived physical threat or danger
  • Threat of death
  • Treatment and invasive procedures

Nursing Diagnosis

  • Fear

Desired Outcomes

  • Patient will express fears and concerns and relates obtainment of increasing physical and psychological comfort.
  • Patient uses effective coping behaviors to decrease fear.

Nursing Interventions

Nursing InterventionsRationale
Nursing Assessment
Encourage the patient to express fears, feelings regarding the condition.Recognizing one’s feelings allows communication thus decreases fear.
Identify present and past measures that the patient uses to cope with fear.This information helps determine the effectiveness of coping strategies practiced by the patient.
Encourage a calm and quiet environment.This intervention avoid or decrease the sensory overload that may cause fear.
Therapeutic Interventions
Maintain a relaxed and accepting demeanor while communicating with the patient.The patient’s feeling of stability increases in a peaceful and non-threatening environment.
Use simple language and easy to understand statements regarding diagnostic procedures and treatment regimen.Simple, clear, and brief instructions are important for the patient to understand any given explanations during excessive fear.
Provide patient and significant others with emotional support.Support system from the family and other significant others is important for the patient in decreasing their level of fear.
Provide safety measures within the home when indicated (e.g., alarm system, safety devices in showers or bathtubs).Provide safety measures within the home when indicated (e.g., alarm system, safety devices in showers or bathtubs).
Allow the patient to have rest periods.Relaxation improves ability to cope. The nurse needs to pace activities, especially to older adults to conserve the patient’s energy.

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:

Originally published on July 14, 2013. 

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