NURSING CARE FOR PATIENTS WITH CONGESTIVE HEART FAILURE AT RSUP HAJI ADAM MALIK

Abstract

Background: Congestive Heart Failure (CHF) remains a critical global health problem characterized by rising incidence rates and poor prognosis. Objectives: This study aimed to execute a comprehensive nursing care process for Mrs. S, a patient diagnosed with CHF in the RA3 Inpatient Ward at RSUP Haji Adam Malik Medan. Methods: A descriptive case study approach was utilized to document the 3x24-hour nursing process, including holistic assessment, diagnosis, intervention planning, implementation, and clinical evaluation. Results: The initial assessment revealed severe dyspnea, extreme fatigue, peripheral edema, and compromised activity tolerance. Five core nursing diagnoses were formulated: decreased cardiac output, activity intolerance, hypervolemia, impaired skin integrity, and impaired gas exchange. Tailored interventions included intensive cardiovascular monitoring, strict fluid restriction (1000–1200 ml/day), energy management with gradual mobilization, and a 2-hour turning protocol to prevent pressure ulcers. After three days of implementation, the clinical evaluation demonstrated significant improvements: marked reduction in dyspnea, stabilized vital signs, complete resolution of peripheral edema, and enhanced functional activity tolerance. Conclusions: Structured, evidence-based nursing care plays a pivotal role in optimizing cardiac performance, managing fluid overload, preventing skin breakdown, and improving the overall clinical outcomes and quality of life for advanced CHF patients