Cardiac failure can be caused by coronary artery disease, cardiomyopathy, hypertension, valve disease, acute illness, diabetes, congenital heart disease, alcohol consumption, smoking, family history, hemorrhage and surgery, pulmonary embolism, excessive sodium intake, and physical or emotional stress. Diagnosis involves echocardiograms, electrocardiograms, and chest x-rays. Nursing diagnoses include decreased cardiac output, excess fluid volume, impaired gas exchange, risk for activity intolerance, and risk of anxiety. Nursing interventions focus on monitoring for edema, distention, and pain; following diet and fluid restrictions; checking vital signs; encouraging breathing exercises; monitoring skin; limiting activity; and providing a calm environment.

1. Cardiac failure

4. Causes
• Coronary arteries disease
• Cardiomyopathy
• Hypertension
• Valve disease
• Acute illness
• Diabetic mellitus
• Congenital heart disease

5. Cont…
• Others
• Alcohol consumption
• Smoking
• Family history
• Hemorrhage and surgery
• Pulmonary embolism
• Excessive sodium intake
• Physical and emotional stress

8. • Echocardiogram
• ECG
• Chest x-ray

12. Nursing diagnosis
• Decrease cardiac output related to heart failure.
• Excess fluid volume related to reduce glomerular filtration, decrease cardiac
output, sodium and water retention.
• Impaired gas exchange r/t fluid in alveoli.
• Risk for activity intolerance r/t decrease cardiac output
• Risk of anxiety r/t cardiac output, hypoxia, diagnosis of heart failure and fear of
death.

13. Nursing intervention
• Assess for presence of peripheral edema, jugular vein distention, hepatomegaly
and abdominal pain
• Follow low sodium diet or fluid restriction.
• Assess the blood pressure for hypotension or hypertension and respiratory rate for
tachypnea.
• Auscultate breath sound every 2 hours and encourage the client to turn, cough
and deep breathing.
• Note color and temperature of skin 4 hourly and monitor peripheral pulses.
• Increase the client to avoid activities that increase the cardiac workload.
• Provide clam environment and explain in advance all procedures and routine.