CARDIAC DISEASE CARE PLANS:
CHF, MI & ATRIAL FIBRILLATION
(Full, Extremely Detailed Nursing Care Plans with Diagnoses, Goals,
Interventions & Rationales)
,1. CONGESTIVE HEART FAILURE
(CHF) – Nursing Care Plan
Overview
Congestive Heart Failure occurs when the heart cannot pump blood effectively,
leading to inadequate tissue perfusion and fluid overload. It can affect the left,
right, or both sides of the heart.
A. Nursing Diagnoses
1. Decreased Cardiac Output related to impaired myocardial contractility.
2. Excess Fluid Volume related to decreased cardiac output and renal
perfusion.
3. Impaired Gas Exchange related to pulmonary congestion.
4. Activity Intolerance related to imbalance between oxygen supply and
demand.
5. Risk for Impaired Skin Integrity related to edema and immobility.
B. Goals / Expected Outcomes
• Patient will maintain stable vital signs and improved cardiac output.
• Patient will have clearer lung sounds, RR < 24/min, SpO₂ > 95%.
• Patient will exhibit reduced edema, balanced intake/output.
• Patient will verbalize reduced fatigue and tolerate activity.
• No skin breakdown or respiratory distress will occur.
,C. Nursing Interventions & Rationales
1. Monitor Cardiopulmonary Status
Interventions
• Monitor BP, HR, RR, O₂ saturation, and cardiac rhythm.
• Assess for S3 heart sound, crackles, frothy sputum, JVD.
• Monitor daily weight, I&O carefully.
• Assess for peripheral edema and skin temperature.
Rationales
• CHF causes decreased cardiac output → vital signs indicate early
deterioration.
• S3 & crackles signal worsening fluid overload.
• Weight increase of >2 lbs/day indicates fluid retention.
• Edema and JVD reflect poor venous return.
2. Improve Oxygenation
Interventions
• Administer oxygen as ordered (2–4 L/min NC).
• Position patient in High Fowler’s.
• Encourage deep breathing & coughing.
Rationales
• Enhances gas exchange and reduces work of breathing.
• Upright positioning decreases venous return → reduces pulmonary
congestion.
,3. Manage Fluid Volume
Interventions
• Administer diuretics (furosemide).
• Restrict fluids as ordered (1–2 L/day).
• Limit sodium intake (2 g/day).
• Evaluate potassium levels (risk of hypo/hyperkalemia).
Rationales
• Diuretics reduce preload and pulmonary congestion.
• Sodium & fluid restrictions decrease fluid retention.
4. Improve Cardiac Output
Interventions
• Administer medications:
o ACE inhibitors (decrease afterload)
o Beta blockers (reduce HR/workload)
o Digoxin (increase contractility)
• Monitor for signs of digoxin toxicity (N/V, vision changes, bradycardia).
Rationales
• These drugs reduce workload and increase output.
5. Reduce Activity Intolerance
Interventions
• Provide rest between activities.
• Gradually increase patient activity.
• Monitor HR during exertion.
, Rationales
• Prevents overexertion of weak cardiac muscle.
6. Patient Teaching
• Daily weights at home.
• Low-sodium diet.
• Take medications consistently.
• Report: worsening edema, dyspnea, weight gain, or fatigue.
D. Evaluation Criteria
• Stable vitals and improved cardiac output.
• Weight decrease and reduced edema.
• Clearer breath sounds, no cyanosis.
• Patient performs ADLs without dyspnea.
2. MYOCARDIAL INFARCTION (MI) –
Nursing Care Plan
Overview
MI occurs when coronary blood flow is blocked, causing myocardial cell death.
Immediate treatment prevents complications.
A. Nursing Diagnoses
CHF, MI & ATRIAL FIBRILLATION
(Full, Extremely Detailed Nursing Care Plans with Diagnoses, Goals,
Interventions & Rationales)
,1. CONGESTIVE HEART FAILURE
(CHF) – Nursing Care Plan
Overview
Congestive Heart Failure occurs when the heart cannot pump blood effectively,
leading to inadequate tissue perfusion and fluid overload. It can affect the left,
right, or both sides of the heart.
A. Nursing Diagnoses
1. Decreased Cardiac Output related to impaired myocardial contractility.
2. Excess Fluid Volume related to decreased cardiac output and renal
perfusion.
3. Impaired Gas Exchange related to pulmonary congestion.
4. Activity Intolerance related to imbalance between oxygen supply and
demand.
5. Risk for Impaired Skin Integrity related to edema and immobility.
B. Goals / Expected Outcomes
• Patient will maintain stable vital signs and improved cardiac output.
• Patient will have clearer lung sounds, RR < 24/min, SpO₂ > 95%.
• Patient will exhibit reduced edema, balanced intake/output.
• Patient will verbalize reduced fatigue and tolerate activity.
• No skin breakdown or respiratory distress will occur.
,C. Nursing Interventions & Rationales
1. Monitor Cardiopulmonary Status
Interventions
• Monitor BP, HR, RR, O₂ saturation, and cardiac rhythm.
• Assess for S3 heart sound, crackles, frothy sputum, JVD.
• Monitor daily weight, I&O carefully.
• Assess for peripheral edema and skin temperature.
Rationales
• CHF causes decreased cardiac output → vital signs indicate early
deterioration.
• S3 & crackles signal worsening fluid overload.
• Weight increase of >2 lbs/day indicates fluid retention.
• Edema and JVD reflect poor venous return.
2. Improve Oxygenation
Interventions
• Administer oxygen as ordered (2–4 L/min NC).
• Position patient in High Fowler’s.
• Encourage deep breathing & coughing.
Rationales
• Enhances gas exchange and reduces work of breathing.
• Upright positioning decreases venous return → reduces pulmonary
congestion.
,3. Manage Fluid Volume
Interventions
• Administer diuretics (furosemide).
• Restrict fluids as ordered (1–2 L/day).
• Limit sodium intake (2 g/day).
• Evaluate potassium levels (risk of hypo/hyperkalemia).
Rationales
• Diuretics reduce preload and pulmonary congestion.
• Sodium & fluid restrictions decrease fluid retention.
4. Improve Cardiac Output
Interventions
• Administer medications:
o ACE inhibitors (decrease afterload)
o Beta blockers (reduce HR/workload)
o Digoxin (increase contractility)
• Monitor for signs of digoxin toxicity (N/V, vision changes, bradycardia).
Rationales
• These drugs reduce workload and increase output.
5. Reduce Activity Intolerance
Interventions
• Provide rest between activities.
• Gradually increase patient activity.
• Monitor HR during exertion.
, Rationales
• Prevents overexertion of weak cardiac muscle.
6. Patient Teaching
• Daily weights at home.
• Low-sodium diet.
• Take medications consistently.
• Report: worsening edema, dyspnea, weight gain, or fatigue.
D. Evaluation Criteria
• Stable vitals and improved cardiac output.
• Weight decrease and reduced edema.
• Clearer breath sounds, no cyanosis.
• Patient performs ADLs without dyspnea.
2. MYOCARDIAL INFARCTION (MI) –
Nursing Care Plan
Overview
MI occurs when coronary blood flow is blocked, causing myocardial cell death.
Immediate treatment prevents complications.
A. Nursing Diagnoses
