Medical-surgical Nursing Demystified

(^28) Medical-Surgical Nursing Demystified

• Exercise testing may show poor cardiac function not evident in a resting
  state.

TREATMENT

Treatment is based on the specific cause. Avoiding the offending drug/treatment is

imperative. Manage the underlying disease and provide cardiac support; however,

few therapies can halt the process of cardiomyopathy.

• Change to a low-sodium diet.


• Beta adrenergic blockers—cause the heart to beat slowly, allowing more
  time for ventricular filling and improve contractile function:
  
  
  • propranolol, nadolol, metoprolol (for hypertropic cardiomyopathy)
  
  
  
  


• Angiotensin-converting enzyme (ACE) inhibitors—to decrease left ventric-
  ular filling pressures.


• Calcium channel blockers—reduced cardiac workload by increasing contrac-
  tile ability:
  
  
  • verapamil (for hypertrophic cardiomyopathy)
  
  
  
  


• Diuretics reduce fluid retention:
  
  
  • furosemide, bumetanide, metolazone (for dilated cardiomyopathy)
  
  
  • spironolactone (aldosterone antagonist)
  
  
  
  


• Administer inotropic agent to enable the heart to have greater contractile
  force:
  
  
  • dobutamine
  
  
  • milrinone
  
  
  • digoxin (for dilated cardiomyopathy)
  
  
  
  


• Administer oral anticoagulant to reduce the coagulation of blood:
  
  
  • warfarin (for dilated and hypertrophic cardiomyopathy)
  
  
  
  


• Implantable cardioverter-defibrillator for high risk.


• Myectomy—incision into septum and removal of tissue.

NURSING DIAGNOSES

• Activity intolerance


• Impaired gas exchange


• Decreased cardiac output