Nursing Care Plan for Cardiomyopathy

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 Outome

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:

  1. 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.
  2. 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
  3. 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
  4. 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).
  5. 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.
  6. 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.

References

Date Published - Oct 30, 2018
Date Modified - Nov 1, 2018