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Created By: Nicole Wiegert, RN, BSN

The Basics of Heart Failure

Self- Management

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Learning ObjectivesAfter completion of this lesson, the patient will be able to:

• accurately check daily weights and assess for a three pound weight gain in one day or five pounds in a week.

• develop a log to track daily weights, blood pressure, symptoms and fluid and sodium intake as directed.

• reflect on the importance of monitoring their symptoms daily and identify a tool that will guide them with symptom monitoring.

• suggest at least one lifestyle modification that can be made to improve their management of heart failure.

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Heart Failure Self-Management• YOU play a key role in optimizing your heart failure treatment

outcomes.-Adherence to self-management is necessary

• Self-management = The decisions and behaviors that patients participate in that affect their health

The following slides will provide some basic tips for heart failure self-management .

(Improving Chronic Illness Care, n.d.)

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Tip #1: Take Your Medications As Prescribed• Keep an updated medication list, carry a copy in your wallet.

-Include: name of med, dose and how often it is taken each day

• If your water-pill is prescribed once a day, take it in the morning.-This may help avoid unnecessary trips to the bathroom at

night.

• Ask for refills at least one week before your meds run out.

• Report any side effects of your meds to your provider.-i.e. dizziness, nausea, changes in sexual function

DO NOT STOP OR TAKE EXTRA MEDICATION WITHOUT FIRST CONSULTING YOUR PROVIDER!!!

(Purcell & Fletcher, 2014)

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Tip #2: Monitor Your Weight Daily• Weigh first thing in the morning.

-Use same scale-Wear the same amount of clothing-Weigh before eating or drinking and after urinating

• Keep a log of your daily weights.-Take this log to your appointments.

• Notify your provider of a 2-3 lb. weight gain in one day or 5 lbs. in 7 days.

-Rapid weight gain may be a sign of fluid build-up if your diet has not changed.

(OSU Wexner Medical Center, 2014 & Purcell & Fletcher, 2014)

Click here to learn more about monitoring daily weights from OSU Wexner Medical Center.

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What Would You Do?Your weight yesterday when you checked it was 204 lbs. This morning when you checked your weight it was 208 lbs.

You should:

A. Do nothingB. Take an extra diuretic (water pill) C. Contact your Provider

Correct Answer: C. Contact your Provider Your provider should be contacted if you have a weight gain of 2-3 lbs. in one day or 5 lbs. in one week. Quick weight gains are usually a sign of fluid build up. Your provider will direct you if medication adjustments are necessary.

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Tip #3: Decrease Your Sodium Intake Foods high in sodium (salt) cause the body to hold on to extra fluid.

• Ask your provider which sodium limit is best for you.-Most patients are asked to consume less than 2,000 mg/day.

• Keep track of your sodium intake each day.

• Some ways to lower sodium in your diet include:- Do not cook with salt, or add salt at the table- Season foods with fresh herbs- Choose fresh foods instead of canned or processed- Read food and beverage labels: pay attention to sodium

content and serving sizes.

• When shopping, low sodium foods = 140 mg or less/serving size

(Purcell & Fletcher, 2014)

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Tip #4: Follow Your Recommended Daily Fluid Intake

• Ask your provider how much fluid you are allowed in one day. -Most patients are asked to limit their fluid to 6-8 cups (8oz.)

per day.

• Remember… foods that are liquid at room temperature should be treated as fluid.

-Popsicles, soup, ice cream, Jell-O, and ice cubes-High moisture foods may also need to be counted (grapes,

strawberries)

• Keep track of your fluid intake (mentally or written).

(Purcell & Fletcher, 2014)

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Tip #5: Find Balance Between Rest and Activity

• Rest-Put your feet up a few times throughout the day.-Consider a nap.

• Activity-Ask your provider about gradually increasing your

exercise.-Choose an exercise that doesn’t make you too tired.-Don’t lift really heavy objects: Ask your provider if you

have a lifting restriction.

• Alternate periods of activity and rest.

(Purcell & Fletcher, 2014)

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Tip #6: Symptom MonitoringDaily symptom monitoring allows you to catch symptoms before they get too serious.

• Call Your Provider if you have new onset or an increase in the following symptoms:

-Sudden weight gain (2-3 lbs. in 1 day or 5 lbs. in 7 days)-Shortness of breath, especially when laying down-Swelling in ankles, legs, feet and abdomen (bloating)-Constant cough-Fatigue-Dizziness or fainting-Chest pain or pressure

View the American Heart Association’s Self-Check Plan Here

(Self-Check Plan for HF Management, 2015 & Purcell & Fletcher, 2014)

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Test Your Knowledge!

To help manage my heart failure I should:

B. Eat as much salt as I want.C. Take my medications as prescribed.D. Both A & C

Correct Answer: D. Both A &C Some heart failure self-management tips include: take your medications as prescribed, monitor daily weights and symptoms, decrease your sodium intake, follow your recommended daily fluid intake and balance rest with activity.

A. Monitor my weight and symptoms on a daily basis.

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ALSO REMEMBER…• Be sure to attend your scheduled follow-up appointments with

your provider.

• Lean on your family, friends and healthcare team for support.

can take control of your heart failure!

If you have questions about your treatment plan or need additional support please speak with your provider.

YOU

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Review: Heart Failure Self-Management Jeopardy

Click Here to play Heart Failure Self-Management Jeopardy

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ReferencesImproving Chronic Illness Care. (n.d.). Retrieved June 10, 2016, from

http://www.improvingchroniccare.org/index.php?p=SelfManagement_Sup

port&s=39

OSU Wexner Medical Center. (2014, June 24). Congestive Heart Failure and

Monitoring Your Weight Daily [Video file]. Retrieved from

https://www.youtube.com/watch?v=HHfcj0g1yHA

Purcell, J. A., & Fletcher, B. J. (2014). A stronger pump: A guide for people with all

types of heart failure. Atlanta, GA: Pritchett & Hull Associates.

Self-Check Plan for HF Management. (2015). Retrieved June 10, 2016 , from

http://www.heart.org/idc/groups/heartpublic/@wcm/@hcm/documents/

downloadable/ucm_477328.pdf