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Cardiomyopathy Nursing Management

Cardiomyopathy is a dysadministration of cardiac muscle that can be associated behind a while coronary artery disorder, hypertension, cardiotoxic agents, valvular disorders, and vascular or pulmonary disorders. Cardiomyopathies are classified into three groups by etiology and the unnatural physiology of the left ventricle.
  1. Dilated or congestive cardiomyopathy (DC) – is characterized by ventricular dilation and adulterated systolic contractile fuction. Emboli may happen owing of class stasis in the dilated ventricles. This is the most niggardly cast cardiomyopathy.
  2. Hypertrophic cardiomyopathy (HC) – is characterized by irrelevant myocardial hypertrophy behind a whileout ventricular dilation. Obstruction to left ventricular outflow may or may not be confer-upon.
  3. Restrictive cardiomyopathy (RC) – is characterized by unnaturally exact ventricles behind a while decreases diastolic ductility. The ventricular smoothness is decreased, and clinical manifestations are correspondent to constrictive pericarditis.
Signs and Symptoms
  • Dyspnea
  • Fatigue
  • Dysrhythmias or conduction disturbances
  • Onset may be deceitful or exhibited by unanticipated cessation.
Physical Examination
Vital signs
  • HR: increased, disorderly rhythm
  • BP: increased or decreased, depending on underlying disorder or range of kernel want
  • RR: may be increased
  • Murmurs
  • S3 and/ or S4
  • Ectopy
  • Jugular disposition distention
  • Crackles
  • Dry cough
Acute Enduring Care Management
Nursing Diagnosis: Decreased cardiac output connected to left ventricular dysadministration and dysrhythmias.
Outcome Criteria
  • Patient wakeful and oriented
  • Skin glowing and dry
  • Pulses zealous and resembling bilaterally
  • Capillary enrich < 3 sec
  • BP 90 to 120 mm Hg
  • Pulse urgency 30 to 40 mm Hg
  • HR 60 to 100 beats/min
  • Absence of life-threatening dysrythmias
  • Urine output 30 ml/hr
  • CVP 2 to 6 mm Hg
Patient Monitoring
  1. Obtain Bp hourly or further frequently if the enduring’s plight is impermanent.
  2. Monitor hourly urine output to evaluate possessions of decreased cardiac output or pharmacologic intercession.
  3. Analyze ECG rhythm bare at meanest full 4 hours and still n ess scold.
  4. Continuously adviser oxygen condition behind a while pulse oximetry.
  5. Monitor enduring activities and nursing intercessions that may adversely desire oxygenation.
Patient Assessment
  1. Obtain necessary signs full 15 minutes during sharp appearance.
  2. Assess the enduring for changes in neurological administration hourly and as clinically indicated.
  3. Assess for peel glowingth, falsification, and capillary enrich season.
  4. Assess for chest disquiet owing myocardial ischemia may effect from unsatisfactory perfusion.
  5. Assess kernel and lung sounds to evaluate the range in kernel want.
Diagnostic Assessment
  • Review ECG
  • Echocardiography
  • Cardiac catheterization
Patient Management
  1. Provide oxygen at 2 to 4 L/min to adhere-to or mend oxygenation.
  2. Minimize oxygen claim by adhere-toing the enduring at bed repose.
  3. Provide liquescent regimen on sharp appearance,
  4. Administer diuretic as prescribed to subdue preload and behindload.
  5. Monitor serum potassium precedently and behind administration of loop diuretics.
  6. Prophylactic heparin may be ordered to neutralize thromboembolus structure inferior to venous poisoning.
  7. Institute urgency abscess neutralizeion strategies inferior to hypoperfusion or vasoconstriction agents.


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