CHF exacerbation post-cath — care plan
Cardiac Output Alteration related to reduced ventricular function and recent acute exacerbation.
- Monitor vital signs, telemetry, and SpO₂ q4h.
- Auscultate heart and lung sounds q shift; document S3/S4 and crackles.
- Administer scheduled cardiac medications on time; assess effect.
Fluid Volume Excess related to impaired cardiac output and sodium/water retention.
- Maintain strict I&O; report UOP <30 mL/hr × 2 consecutive hours.
- Daily weight at the same time, same scale; trend across shifts.
- Administer IV diuretics as ordered; recheck potassium afterward.
Skin Integrity Alteration related to right femoral cath access site.
- Assess groin site q1h × 4 then q4h: bleeding, hematoma, distal pulses, color, sensation.
- Maintain bed rest with HOB ≤30° per facility post-cath protocol.
- Notify provider immediately for active bleeding or expanding hematoma.
Knowledge Deficit related to home medication adherence and weight monitoring.
- Teach to weigh daily and call provider for ≥2 lb in 24h or ≥5 lb in a week.
- Reinforce reasons for each home medication and timing.
- Provide written discharge instructions and confirm follow-up appointment.
Coordinate with cardiology, case management, and home health. Escalate for bleeding at access site, hemodynamic instability, or escalating dyspnea.
