Nursing Care Plan (NCP) for Cardiomyopathy

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Outline

Pathophysiology

Cardiomyopathy is an abnormality of the cardiac muscle that leads to functional changes or impairment. There are three types: Dilated, Hypertrophic, and Restrictive.

Etiology

Cardiomyopathy is typically caused by prolonged, uncontrolled hypertension, congestive heart failure, or congenital diseases. In each case the heart is having to work extra hard – the ventricles begin to change shape (or remodel) in response to the extra work.

Desired Outcome

To control HTN and manage symptoms and prevent long-term complications of low cardiac output. The only “cure” is heart transplant.

Cardiomyopathy Nursing Care Plan

Subjective Data:

  • Symptoms of Heart Failure
    • Fatigue
    • Chest Pain
    • Shortness of Breath
  • Dyspnea on exertion

Objective Data:

  • Signs of Heart Failure
    • Extra Heart Sounds (S3, S4)
    • Poor peripheral perfusion
    • Dysrhythmias
    • JVD
    • Crackles in lungs
  • Enlarged heart on imaging
  • ↓ Stroke volume
  • ↓ CVP (preload)

Nursing Interventions and Rationales

  • Monitor CV status & VS

 

Cardiomyopathy can mimic heart failure and is often caused by hypertension. It’s important to monitor the patient’s cardiovascular status and vital signs to be alert to any evidence of decompensation.

 

  • Assess Oxygenation, Apply O2 as needed

 

Because cardiac output is compromised, oxygenation may be compromised as well due to poor perfusion and fluid backing up in the lungs. Assess SpO2 and give supplemental oxygen

 

  • Administer antihypertensives

 

Controlling hypertension is important to control symptoms as well as to prevent any further damage to the heart muscle.

  • Beta Blockers
    • ↓ workload of heart
  • ACE Inhibitors
    • ↓ afterload
  • ARBs
    • ↓ afterload
  • Diuretics
    • ↓ preload

 

  • Encourage rest and minimize stress

 

Because of the poor cardiac output, patients will be short of breath and easily fatigued. Encourage frequent rest periods and clustered activities.

Minimizing stress can decrease blood pressure and workload on the heart, as well as decrease inflammatory chemicals within the heart muscle (↓ cortisol).

 

  • Monitor for s/s heart failure

 

Cardiomyopathy can mimic heart failure. The patient may experience signs of poor perfusion such as weakness, pale, clammy skin, and diaphoresis, as well as shortness of breath and pink frothy sputum due to pulmonary edema.

 

  • Educate patient on low-sodium diet (DASH diet)

 

A low sodium diet should be followed to help decrease hypertension and water retention (volume overload). This involves avoiding processed or canned foods, not adding salt to food, and avoiding sodas.

Writing a Nursing Care Plan (NCP) for Cardiomyopathy

A Nursing Care Plan (NCP) for Cardiomyopathy starts when at patient admission and documents all activities and changes in the patient’s condition. The goal of an NCP is to create a treatment plan that is specific to the patient. They should be anchored in evidence-based practices and accurately record existing data and identify potential needs or risks.


References

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Transcript

Let’s take a look at the care plan for cardiomyopathy. 

 

So, in this lesson, we will briefly take a look at the pathophysiology and etiology of cardiomyopathy. We’re also going to take a look at additional things that will be included in this care plan, like subjective and objective data, as well as nursing interventions and rationales. 

 

So, cardiomyopathy is the abnormality of the cardiac muscle that leads to impairment or functional changes of the cardiac muscle. There are three kinds of cardiomyopathy, including dilated, hypertrophic and restrictive. So, cardiomyopathy is typically caused by prolonged, uncontrolled hypertension, congestive heart failure, or congenital diseases. In each of these cases, the heart muscle must work extra hard, which then changes the shape or remodels the heart in response to the extra work. So, this remodeling predominantly occurs with the left ventricle in dilated and hypertrophic cardiomyopathy, which makes it hard to pump blood out to the body.

 

So, the desired outcome is to control hypertension, manage the symptoms and prevent long-term complications of low cardiac output. It’s important to know that the only cure is a heart transplant. So, let’s take a look at the subjective and objective data that your patient with cardiomyopathy may present with. Remember subjective data, these are going to be things that are based on your patient’s opinions or feelings. So, these things may include dyspnea on exertion, as well as symptoms of heart failure, including fatigue, chest pain, shortness of breath. 

 

Objective, or measurable data, which your patient may present with might include signs of heart failure, including extra heart sounds S3, S4, poor peripheral perfusion, dysrhythmias, JVD, crackles in the lungs, an enlarged heart on imaging, decreased stroke volume and decreased CVP or preload. 

 

Okay, let’s take a look at some of the nursing interventions important for a patient with cardiomyopathy. Monitor cardiovascular status, as well as vital signs. Cardiomyopathy can mimic heart failure and is often caused by hypertension. It’s super important to monitor the patient’s cardiovascular status and vital signs to determine any signs of decompensation.  Assessing the oxygenation status of your patient is also super important because with cardiomyopathy, cardiac output is compromised and oxygenation is also compromised due to poor perfusion and also fluid backing up in the lungs. So, assess SP02 and apply supplemental oxygenation as needed. 

 

Another nursing intervention includes administering anti-hypertensives to control hypertension, to control the symptoms and to prevent any further damage to the heart. Beta blockers work by decreasing the workload on the heart, ACE inhibitors work to decrease the afterload, ARBs or angiotensin 2 receptor blockers also decrease afterload and diuretics decrease preload. For patients with cardiomyopathy because of the low cardiac output, they are easily fatigued and become short of breath, so encourage frequent rest periods and cluster activities. Minimizing stress is also important to decrease the blood pressure as well as the workload on the heart and decrease inflammatory chemicals like cortisol. 

 

Okay, because cardiomyopathy can mimic heart failure, they may experience signs of poor perfusion like weakness, pale and clammy skin, and diaphoresis as well. Also, shortness of breath with pink frothy sputum due to pulmonary edema. A low sodium diet should be followed to help decrease hypertension as well as water retention and volume overload. So, this type of diet invoice involves avoiding processed or canned foods, soda and also not adding salt to food. 

 

Okay, guys, here is a look at the completed care plan for cardiomyopathy. 

 

That’s it for this care plan on cardiomyopathy. We love you guys. Go out and be your best self today and as always, happy nursing!

 

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