Cardiac Disease Management Program
Home Monitoring
Home monitoring of the cardiac patient is made up of the following categories:
- Daily self-monitoring
- Infusion related monitoring
- Serum lab values
- Efficacy of agent
Self Monitoring
With the direction of the home cardiac nurse the patient will be instructed to monitor
temperature, pulse, respirations, weight, and I&O if appropriate. I&O may be strict or general
depending on the individual patient’s status. Patients will be instructed to obtain a blood
pressure kit and take daily readings as necessary.
Infusion Related Monitoring
An individual treatment plan will be designed and recommendations made by Home Solutions
clinical personnel. The infusion-related monitoring plan will be dictated by patient stability and
physician preference.
Typically Home Solutions clinical personnel monitor the following:
- Rate and rhythm of apical and radial pulse before starting the cardiac infusion and about 10
minutes after starting the infusion
- Overall Cardiac Output is monitored with each nursing visit. Changes in blood pressure,
urine output, changes in mentation, peripheral circulation, or activity level is reported
- Clinical pharmacists watch for altered potassium or magnesium levels, BUN and Creatine
- Written patient education materials are provided by the cardiac nurses that explain symptoms
of cardiac output changes
- Vital signs and weight is recorded and reported to the ordering physician
- Intake and output is discussed and monitored per the individual treatment plan. The patient’s
team clinical pharmacist can refer patients to our dietician for review if needed.
- Cardiac nurses assess lung sounds, abdominal girth, extremity edema, and skin tone
- Patients are shown how to record daily weights and are provided with a log book.
Drug Efficacy
Home Solutions cardiac homecare nurses and experienced clinical pharmacists consult with the
patient frequently to assess any and all changes in cardiac symptoms as demonstrated by
lessening of dyspnea, orthopnea, fatigue and edema. Under direction f the ordering physician,
medication changes and/or dose/rate changes are made to obtain acceptable response by the
patient.
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