Heart Failure (CHF) Nursing Diagnosis, Care Plans, and Nursing Interventions

Overview

Heart Failure (Congestive Heart Failure – CHF) is a chronic, progressive condition in which the heart muscle is unable to pump blood efficiently enough to meet the body’s needs. This results in inadequate oxygen delivery to tissues and organs, leading to symptoms such as shortness of breath, fatigue, and fluid retention.

Causes (Related to):

  • Coronary artery disease (CAD)
  • Hypertension
  • Valvular heart disease
  • Cardiomyopathy
  • Myocardial infarction
  • Congenital heart defects
  • Arrhythmias

Signs and Symptoms:

  • Dyspnea on exertion or at rest
  • Orthopnea
  • Paroxysmal nocturnal dyspnea
  • Fatigue and weakness
  • Peripheral edema
  • Rapid weight gain from fluid retention
  • Jugular venous distention (JVD)
  • Crackles/rales in the lungs
  • Decreased exercise tolerance

Nursing Diagnoses:

  • Decreased Cardiac Output
  • Excess Fluid Volume
  • Activity Intolerance
  • Impaired Gas Exchange
  • Knowledge Deficit

Nursing Interventions:

  • Monitor vital signs, especially blood pressure, heart rate, and oxygen saturation.
  • Assess for signs of fluid overload, such as edema, weight gain, and lung crackles.
  • Encourage a low-sodium diet to help prevent fluid retention.
  • Administer diuretics, ACE inhibitors, beta-blockers, or other prescribed medications as ordered.
  • Monitor daily weights and fluid intake/output.
  • Position patient in semi-Fowler’s or high Fowler’s to ease breathing.
  • Educate patient on lifestyle modifications, medication adherence, and early symptom recognition.
  • Encourage gradual increases in activity as tolerated.

Patient Education:

  • Importance of daily weight monitoring.
  • Recognizing signs of worsening heart failure (e.g., sudden weight gain, increased shortness of breath).
  • Limiting sodium and fluid intake as advised by healthcare provider.
  • Adhering to prescribed medications and follow-up appointments.
  • Engaging in safe levels of physical activity.

Expected Outcomes:

  • Patient will maintain stable weight and fluid balance.
  • Patient will verbalize understanding of condition, medications, and self-care measures.
  • Improved tolerance to physical activity without worsening symptoms.
  • Reduced hospitalizations related to exacerbations of CHF.
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