Nursing Assessment for Cardiomyopathy

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Questions and Answers

What is a critical aspect of managing patients with cardiomyopathies?

Patient and family education about symptoms and management (correct)

Recommending complete bed rest at all times

Avoiding all dietary restrictions

Increased physical activity without rest

Which lifestyle modification is recommended for patients with cardiomyopathy?

Maintaining an appropriate weight (correct)

Increasign sodium in the diet

Engaging in high-intensity exercise daily

Continuing smoking and alcohol consumption

What should the nurse monitor for when assessing a patient with cardiomyopathy?

Complete absence of symptoms

Respiratory patterns and presence of edema (correct)

Decreased heart rate and blood pressure

Weight loss and increased energy

Which medications should be avoided in the treatment of patients with Hypertrophic Cardiomyopathy (HCM)?

Nitrates and other vasodilators Signup and view all the answers

What is an important assessment finding for a nurse to document in a patient with cardiomyopathy?

Increased shortness of breath and dyspnea with exertion Signup and view all the answers

How should a nurse approach the management of a patient with recent surgery for cardiomyopathy?

Apply care similar to other open-heart surgery patients Signup and view all the answers

What symptom may indicate worsening heart failure in a patient with cardiomyopathy?

Severe paroxysmal nocturnal dyspnea Signup and view all the answers

Which of the following is a key part of the nursing assessment for a patient with cardiomyopathy?

Evaluating family history of cardiomyopathy Signup and view all the answers

What is a significant goal of care for a patient diagnosed with cardiomyopathy?

The patient will maintain blood pressure within specified limits. Signup and view all the answers

What nursing intervention can help reduce cardiac workload in a patient with cardiomyopathy?

Elevating the head of the bed. Signup and view all the answers

Which vital sign change may indicate compensatory mechanisms failing in a patient with cardiomyopathy?

Significant increase in heart rate. Signup and view all the answers

What indicates a potential worsening of heart failure in a patient with cardiomyopathy?

Increased brain natriuretic peptide levels. Signup and view all the answers

Which symptom should a nurse monitor for that may signify decreased perfusion in a patient with cardiomyopathy?

Alterations in peripheral capillary refill time. Signup and view all the answers

What lifestyle change should patients with cardiomyopathy be encouraged to adopt?

Alter lifestyle to accommodate a reduced activity level. Signup and view all the answers

What nursing action should be taken when administering oxygen therapy to a patient with cardiomyopathy?

Provide oxygen therapy per prescription. Signup and view all the answers

What educational topic should nurses cover with patients managing cardiomyopathy at home?

Understanding the disease process. Signup and view all the answers

Study Notes

### Nursing Assessment and Care for Cardiomyopathy

Patient Education: Vital for management, emphasizing symptom recognition and disease understanding.
Activity Restriction: May be needed, encourage energy conservation during activities of daily living (ADLs) by alternating periods of activity with rest.
Lifestyle Modifications:
- Limit salt, fat, and fluids in the diet.
- Engage in regular exercise.
- Maintain an appropriate weight.
- Quit smoking.
- Limit or eliminate alcohol.
- Manage stress.
HCM-Specific Care:
- Similar to myocardial ischemia care.
- Avoid nitrates and vasodilators due to worsening heart failure.
- Surgical intervention requires similar post-operative care as open-heart surgery.
Genetic Counseling: Important for identifying family members at risk.

### Assessment for Cardiomyopathy

Subjective and Objective Data:
- Observation and Patient Interview:
  - Review history for hypertension, diabetes, cardiac disease, previous heart failure, and family history of cardiomyopathy.
  - Note shortness of breath, dyspnea on exertion, decreased activity tolerance, sleep patterns (paroxysmal nocturnal dyspnea, pillow use), recent weight gain, coughing, chest or abdominal pain, anorexia, nausea.
  - Review current medications, diet, activity, and recent health changes.
- Physical Examination:
  - Assess vital signs (apical and peripheral pulses).
  - Observe general appearance (work of breathing, ease of conversation, position changes, anxiety).
  - Examine skin and mucous membranes (color), jugular venous distension (JVD), capillary refill, edema.
  - Auscultate heart and breath sounds.
  - Palpate chest for heart size.
  - Examine abdomen (contour, right upper quadrant tenderness, liver enlargement), and auscultate bowel sounds.
  - Obtain blood for testing as needed.

Cardiomyopathy Diagnosis

Appropriate problem identification for patients with cardiomyopathy includes:
- Decreased cardiac output (CO)
- Fatigue
- Fluid volume excess
- Inability to tolerate activity
- Lacks knowledge of disease process
- Grieving

Cardiomyopathy Planning

The plan of care is based on the type and severity of cardiomyopathy.
Goals may include:
- Maintaining blood pressure (BP) within specified limits.
- Altering lifestyle to adjust to reduced activity level caused by the disease process.
- Modifying diet to support long-term management of the condition.

Cardiomyopathy Implementation

Nurses must monitor for subtle changes in vital signs and level of consciousness (LOC):
- Alterations in peripheral capillary refill time, pulse rate or volume, and LOC may be early warning signs of decreased perfusion.
In many cases, the patient and family manage the condition in the home.
Monitor Cardiac Output
- Nursing interventions that address decreased stroke volume (SV) and tissue perfusion include:
  - Encourage periods of rest throughout the day.
  - Elevate the head of the bed to reduce work of breathing (WOB).
  - Provide a bedside commode and assist with activities of daily living (ADLs).
  - Instruct the patient to avoid the Valsalva maneuver.
- These interventions reduce cardiac workload.
- Medications that increase CO and increase contractile effectiveness should be administered as ordered.
- Oxygen therapy is indicated when hypoxia has been found.
- Deliver oxygen therapy per prescription to reduce ischemia and improve perfusion.
Vital signs and oxygen saturation should be monitored.
- It is common for these patients to experience tachycardia due to the sympathetic nervous system (SNS) stimulation in response to low CO.
- Vasoconstriction may cause early elevations in diastolic BP; however, as compensatory mechanisms fail, BP falls.
Brain natriuretic peptide (BNP) is a cardiac neurohormone secreted from the ventricles when they are under stress.
- Levels and trends should be monitored as an indicator of heart failure (HF) severity.
Regular heart and lung sound auscultation provides important clinical information.
- Poor cardiac function can result in diminished S1 and S2 sounds; S3 (ventricular gallop) or S4 (atrial gallop) may be present in early HF.
- Basilar crackles can indicate deteriorating HF.

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Description

Explore essential nursing assessments and care strategies for patients with cardiomyopathy. This quiz covers patient education, lifestyle modifications, and specific care considerations for hypertrophic cardiomyopathy. Test your knowledge on best practices for managing this condition and supporting patient well-being.