GRP 4 Report Concept Map

MODIFIABLE RISK FACTORS:
Concept Map NON - MODIFIABLE RISK FACTORS:

 Lifestyle
 Age (65 years and older)
 Smoking  Family history
Myocardial dysfunction  Gender (Men)
 Ethnicity (Black)
 Diet
 Ischemic heart disease
 Myocardial infarction
 Physical inactivity  Valve disease
 Alcohol, cocaine abuse
 Obesity  Hypertension
 Alcohol consumption
↓STROKE VOLUME
↓CARDIAC OUTPUT
Structural changes attempt to ↑ Stroke volume ↑ Heart Rate KIDNEY

(less time to fill the heart)
Dilated Cardiomyopathy
(Thin ventricle, Enlarged heart but weaker)
Renin
Hypertrophic Cardiomyopathy
(Thicker walls but stiffer) Angiotensin
Aldosterone
Aldosterone
causes
Nursing management:
Nursing Management:
 Establish consuming oral diuretics early in the morning
 Assess vital signs
 Monitor closely by auscultating the lungs
 Develop a schedule that promotes Na+pacing
and H2O& prioritization
Retention of
 Monitor daily body weight
activities
 Assist the patient to adhere to a low-sodium diet by reading
 Assess the physical activity level and mobility of the patient
food labels avoiding processed foods
 Assess the need  forAssist
ambulance VOLUME OVERLOAD
aids
the patient to plan fluid intake throughout the day
 Assess the vital signs and oxygen saturation
while respecting the patient’sleveldietary
before,preferences
during and immediately
 Monitor after
theanamount
activityof fluid intake closely
 Assess the degree
 Consult pharmacistthe
of fatigue felt after activity provider about the possibility
or primary
DIAGNOSTIC TEST:  Referral to a cardiacofrehabilitation
maximizing the program
amountmay be indicated
of medication of&IVSymptoms
Signs fluid
 Chest X-ray
 12 Lead ECG Congestion
 Serum Electrolytes  Dyspnea
 Orthopnea
 Blood Urea Nitrogen (BUN)
 Paroxysmal Nocturnal Dyspnea
 Creatinine
 Cough (recumbent/ Exertional)
 Liver function test
Chronic Heart Failure  Pulmonary crackles that do not clear with cough
 Thyroid stimulating test  Weight gain (rapid)
 Complete Blood Count (CBC)  Dependent edema
 BNP  Abdominal bloating/discomfort
 Routine Urinalysis  Ascites
 Cardiac stress test/ Cardiac catheterization  Jugular venous distention
 Echocardiogram  Sleep disturbance (anxiety/air hunger)
MANEFESTATION  Fatigue
Poor perfusion/Low cardiac output

 Decreased exercise tolerance
LEFTSIDE HEART FAILURE  Muscle
RIGHTSIDE HEARTwasting/weakness
FAILURE
 Anorexia/nausea
 Unexplained weight loss
 Lightheadedness/dizziness
Peripheral Edema  Unexplained confusion/Altered mental status
Pulmonary Edema  Resting tachycardia
1. Activity intolerance related to decreased CO  Daytime
2. Excessive fluid volume related to theoliguria
HF syndrome
with recumbent nocturia
 Cool/Vasoconstricted extremities
 Pallor/cyanosis
3. Anxiety related to clinical manifestations of Heart Failure
4. Powerlessness related to chronic illness and hospitalizations
Nursing management:
 Promote physical comfort Nursing management:

 Provide psychological support
 Oxygen may be given during an acute event to diminish the work of  Provide help to the patient by recognizing their choices to get
breathing and increase the patient’s comfort positive influence on the outcomes of their treatment
 Assess the needs of family caregivers, and provide support to them  Listen actively to patients as it encourages them to express
 Educate the patient and family about techniques for controlling their concerns and ask questions
anxiety and avoid anxiety-provoking situations  Provide the patient with decision making opportunities
 Encourage to use relaxation techniques to control anxious feelings  Provide encouragement
 Assist to differentiate between factors that can and cannot
be controlled
 Screening patient for depression for treatment
5. Ineffective family health management
Nursing management:
 Manage effectively the heart failure regimen to assist

patients and families to prevent hospitalizations
 Manage episodes of acute decompensated HF
 Develop a comprehensive teaching and discharge plan to
prevent hospital readmissions and increase the patient’s
quality of life
LEGEND:
RISK FACTORS
PATHOPHYSIOLOGY
DIAGNOSTIC TEST
SIGNS & SYMPTOMS
INTERVENTIONS
NURSING DIAGNOSIS

GRP 4 Report Concept Map

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MODIFIABLE RISK FACTORS:

Concept Map NON - MODIFIABLE RISK FACTORS:

Structural changes attempt to ↑ Stroke volume ↑ Heart Rate KIDNEY

Poor perfusion/Low cardiac output

 Promote physical comfort Nursing management:

 Manage effectively the heart failure regimen to assist

SIGNS & SYMPTOMS

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