System Illness/ Signs/Symptoms Diagnostics/Labs Medical Management Surgical Management Nursing Intervention

Disease (at least 6 clinical

features)

Cardiovascular Left-sided HF Dyspnea  ECG  Pharmacologic Therapy  Heart transplantation  Promoting activity tolerance. Managing fluid
 ACE Inhibitors. Angiotensin II volume.
System Cough  Chest x-ray Receptor Blockers.  Percutaneous
 Beta Blockers. Diuretics. coronary intervention  Controlling anxiety.
Orthopnea  Sonograms (PCI, also referred to
Diuretics
(echocardiography, as angioplasty)  Minimizing powerlessness
Hemoptysis  Calcium Channel Blockers
Doppler and
transesophageal  Coronary artery
Adventitious breath
echocardiography) bypass
sounds
 Nutritional Therapy
 Heart scan  Sodium restriction. Patient  Valve replacement
Pulmonary
congestion compliance. Patient
 Positron emission compliance is.
tomography (PET)
scan

 Cardiac  Additional Therapy

catheterization  Supplemental Oxygen.
Cardiac Resynchronization
 Bleeding and Therapy.
clotting times  Ultrafiltration..
 Cardiac Transplant
 Electrolytes

 Arterial blood
gases (ABGs)

 BUN/creatinine

 Complete blood
count (CBC)

Pericarditis Dyspnea  chest xray  Analgesics and NSAIDs such  Pericardiectomy  Relieving pain
as aspirin, indomethacin, and
Chest pain ibuprofen are prescribed for
pain relief during acute phase.
Weakness and  electrocardiogram  Enhancing knowledge about pericarditis
tiredness and self-care management

Cough  Corticosteroids can be used as

 echocardiogram
a n alternative when NSAIDs
Palpitations  Monitoring and managing
are contraindicated if the
Fever patient has kidney disease. Potential complications
 cardiac mri
  ct scan  Pericardiocentesis is a
procedure in which some
pericardial fluid is removed.
 cardiac
catheterization
 Pericardial window. An
opening made in pericardium,
may be performed to allow
 CBC
continuous drainage into the
chest cavity.

 ESR

Myocardial Chest pain that  Electrocardiogram  Pharmacologic Treatment  Coronary angioplasty  Administer oxygen along with medication
Infarction may feel like (ECG or EKG). and stenting. therapy to assist with relief of symptoms.
pressure, tightness,
pain, squeezing or  Coronary artery  Encourage bed rest with the back rest
 Blood tests.  Aspirin. bypass surgery elevated to help decrease chest discomfort
aching.
(CABG). and dyspnea.
Pain or discomfort  Chest X-ray.  Clot busters (thrombolytics or
that spreads to the  Encourage changing of positions frequently
fibrinolytics)..
shoulder, arm,  Echocardiogram. to help keep fluid from pooling in the bases
back, neck, jaw, of the lungs.
 Other blood-thinning
teeth or sometimes  Coronary
the upper belly. medications.  Check skin temperature and peripheral
catheterization pulses frequently to monitor tissue
Cold sweat.
(angiogram).  Nitroglycerin perfusion.
Fatigue.
Cardiac CT or MRI.  Provide information in an honest and
Heartburn or  Morphine..
indigestion. supportive manner.
Lightheadedness or  Beta blockers. ACE inhibitors..
 Monitor the patient closely for changes in
sudden dizziness. cardiac rate and rhythm, heart sounds,
 Statins.
Nausea. blood pressure, chest pain, respiratory
Dyspnea or status, urinary output, changes in skin
shortness of color, and laboratory values.
breath.

Cardiomyopathy Dyspnea (especially  Blood tests  Blood pressure medications.  Biventricular  Encourage the patient to rest.
with exertion)  Chest X-ray Different types of drugs may pacemaker.
 Electrocardiogram  Provide supplemental oxygen.
be used to lower blood
(EKG or ECG)  Implantable
Fatigue  Administer medications as indicated.
 Holter and event pressure, improve blood flow
cardioverter-
monitors and reduce the strain on the  Prepare for pacemaker insertion.
Swelling in the  Echocardiogram defibrillators (ICD)
heart. Such medications
(Echo)
ankles, feet, legs,  Stress test include beta-blockers,  Left ventricular
abdomen and veins angiotensin-converting assist devices
in the neck
enzyme (ACE) inhibitors and (LVAD)
angiotensin II receptor
Dizziness
blockers (ARBs).

Lightheadedness  Sacubitril/valsartan
(Entresto). This drug combines
Fainting during an ARB with another type of
physical activity medicine to help the heart
better pump blood to the rest
Arrhythmias of the body. It's used to treat
(abnormal
those with chronic heart
heartbeats)
failure.

Chest pain,  Water pills (diuretics). A

especially after
diuretic removes excess fluid
physical exertion or
heavy meals and salt from the body. Too
much fluid in the body strains
Heart murmurs the heart and can make it
(unusual sounds difficult to breathe.
associated with
heartbeats)  Digoxin (Lanoxin). This drug
can strengthen heart muscle
contractions. It also tends to
slow the heartbeat. Digoxin
may reduce heart failure
symptoms and make it easier
to be active.

 Ivabradine (Corlanor). Rarely,

this drug may be used to
manage heart failure caused
by dilated cardiomyopathy.

 Blood-thinners
(anticoagulants). These drugs
help prevent blood clots.
Coronary Artery Chest pain or ● Electrocardiogr  Cholesterol drugs. Aspirin.  Coronary
Disease (CAD) discomfort (angina) am (ECG or angioplasty and
Weakness, light- EKG)  Beta blockers.
stent placement..
headedness,  Monitor blood pressure, apical heart rate,
● Echocardiogra  Calcium channel blockers.
nausea (feeling sick  Coronary artery and respirations every 5 minutes during an
m
to your stomach), anginal attack.
 Angiotensin-converting bypass graft
or a cold sweat. ● Exercise stress
enzyme (ACE) inhibitors and surgery (CABG).  Maintain continuous ECG monitoring or
Pain or discomfort test
obtain a 12-lead ECG, as directed, monitor
in the arms or angiotensin II receptor
● Nuclear stress for arrhythmias and ST elevation.
shoulder. blockers (ARBs).
test
Dyspnea or  Place patient in comfortable position and
shortness of ● Heart (cardiac)  Nitroglycerin. administer oxygen, if prescribed, to
breath. CT scan enhance myocardial oxygen supply.
 Ranolazine.
● Cardiac  Identify specific activities patient may
catheterization engage in that are below the level at which
and angiogram anginal pain occurs.

 Reinforce the importance of notifying

nursing staff whenever angina pain is
experienced.

 Encourage supine position for dizziness

caused by antianginals.

 Be alert to adverse reaction related to

abrupt discontinuation of beta-adrenergic
blocker and calcium channel blocker
therapy. These drug must be tapered to
prevent a “rebound phenomenon”;
tachycardia, increase in chest pain, and
hypertension.

 Explain to the patient the importance of

anxiety reduction to assist to control
angina.

 Teach the patient relaxation techniques.

 Review specific factors that affect CAD

development and progression; highlight
those risk factors that can be modified and
controlled to reduce the risk.
Congestive Heart Fatigue and  ACE inhibitor  Biventricular pacing  Encourage to exercise.
Failure weakness  Blood tests  ARB’s therapy  Low salt diet.
 Chest X-ray  Diuretic  Heart transplant  Change lifestyle.
Dyspnea  Electrocardiogram  Renin-angiotensin  Implanted  Take prescribed medication.
 Stress test inhibitor Cardioverter-
Irregular breathing
 CT Scan Defibrillator (ICD)
Nausea  Magnetic
Resonance Imaging
Lack of appetite

Chest pain