Congestive Heart Failure Patient Teaching

CONGESTIVE HEART FAILURE
PATIENT TEACHING
What is Heart Failure?

Congestive Heart Failure occurs when the heart loses
its ability to pump enough blood to meet the bodys
needs. Because the heart is not pumping blood
properly, excess fluid can accumulate.
Fluid can accumulate in the lungs and result in

pulmonary edema or shortness of breath. Sometimes
patients will experience swelling of the feet and
ankles, or in the abdomen.
What Causes Heart Failure?

Congestive Heart Failure can be caused by a number
of conditions that damage the heart muscle, including
heart attacks, or heart infections, coronary artery
disease, untreated hypertension, excessive alcohol
intake, smoking or recreational drug use.
Heart failure can also be caused by damage to, or
abnormalities in the heart valves or an irregular
heartbeat.
Major risk factors include smoking, high cholesterol
levels, hypertension, diabetes and obesity. Many of
these risk factors can be controlled through lifestyle
changes or medications.
Symptoms and Treatment

Symptoms of Congestive Heart Failure include:
* Shortness of breath with activity or when lying
flat
* A dry constant cough which may be worse at night
* Swelling in the feet, legs, or abdomen
* Weakness
* Fatigue
* Sudden weight gain.
Prevention is the best treatment. A low sodium diet,
regular exercise, consuming alcohol in moderation
and not smoking are examples of healthy lifestyle
changes.
Medication Management
Heart failure medications are used to reduce your
symptoms and manage your condition. There are
several classifications of heart medications: beta
blockers, ACE inhibitors, diuretics (fluid pills), and
Digoxin. Familiarize yourself with your medications
and follow your doctors instructions. Unfortunately,
one of the most common reasons for rehospitalization for heart failure is not taking
medications properly.
Carry a medication list and know the names and
doses of the drugs you are taking. Take your
medicine at the same time every day. Keep your
medications in the original container and you may
want to use a weekly pill box to ensure that you dont
miss a dose. Make sure that you remember to call in
refills before you run out of pills.
We have been asked to provide you with intravenous
(IV) medication to assist with the management of
your congestive heart failure symptoms.
Inotropic Therapy
Your doctor has prescribed an inotropic therapy to
help manage the symptoms of your heart failure.
This medication is administered through an IV using
an electronic pump. You will be taught to manage
the administration of the medication, as well as
maintenance of your IV catheter. The inotropic
medication stimulates the injured or weakened heart
to pump harder to send blood through the body. It
will improve symptoms of shortness of breath and
swelling in the legs and abdomen.
You have been provided with two ambulatory
infusion pumps to administer your medication. You
will alternate them each time you change your
medication bag. You can have the second pump
completely set up before disconnecting the first one,
so that there is no interruption in the medication
administration. If your pump is malfunctioning,
notify the pharmacy and it will be replaced
immediately. (Please refer to the patient teaching
instructions provided in your new patient packet)
The pumps are much smaller than those used in the
hospital and can be packed in a fanny pack so you
can do your normal daily activities
The pharmacy will deliver your medication weekly

and it will need to be stored in the refrigerator. A
new supply will automatically be delivered each
week. If there is a mishap with a bag please notify
the pharmacist, so that you always have enough
medication to last until the next delivery arrives.
There should always be at least one medication bag
in your refrigerator. Remember to use the oldest
bags first pay attention to the expiration dates!
When changing your bags, do not flush the IV
catheter. This will inadvertently give you a bolus
(dose) of the medication instead of the slow steady
rate that the pump delivers. If you have a double
lumen catheter, keep the pump on the same side each
time you hook up. You will be taught by your nurse
how to flush the other lumen. Your IV dressing will
be changed by your nurse.
Monitoring your Weight

It is extremely important to monitor your weight
daily. An increase in weight can be an early
indication of worsening of your congestive heart
failure.
Each morning before breakfast and after urinating,
weigh yourself. You should have on the same
amount of clothing, and use the same scale in the
same spot daily. Record your weight on your chart.
Call your nurse or pharmacist if you experience a
2-3 pound weight gain over a 2 day period or 5
pounds in one week.
If caught early, an additional diuretic (fluid pill) can
be prescribed and possibly avoid the need for rehospitalization from fluid overload.
Salt and Fluid Restrictions

Your doctor may have prescribed a sodium (salt)
and/or fluid restriction. You should familiarize
yourself with the amount of salt and fluids you are
allowed each day. Standard restrictions for patients
with congestive heart failure are 2 grams of sodium
and 1 liter of fluid daily.
Salt causes the body to hold onto water causing an
increase in body weight, swelling and shortness of
breath. If you eat too much salt or drink too much
fluid, your bodys water content may increase and
make your heart work harder. Take the salt shaker
off the table but that alone is not enough! Learn to
read the labels on your foods. Avoid processed foods
and canned soups and vegetables. Choose fresh or
frozen vegetables instead. Processed meats, like
bacon, ham, bologna or hot dogs often are high in
sodium. When you go out to eat, ask your server to
have the cook prepare your meal without added salt.
In addition to restricting your salt intake, you need to

monitor the amount of fluid you drink daily. Plan out
your fluid intake to include the amount of water
needed to take your medications, as well as a drink
with meals. A liter of fluid a day is probably much
less than you are used to drinking, and you dont
want to consume all your daily allotment by
lunchtime!
Dont forget to include the fluids in the foods you are
eating, particularly soups and broths. Use hard
candies or ice chips in moderation for dry mouth
throughout the day.
Remember, you are the most

important member of your care team!
To avoid a trip back to the hospital
Take your oral medications as
prescribed
Weigh yourself daily and notify
your RN or pharmacist of any
increase in your weight
Restrict your salt and fluid
intake
Administer your IV inotropic
medication as ordered and call the
pharmacy with any problems
Weight Chart
***Call your nurse or pharmacist if you have 2-3
lb weight gain in 2 days or a 5 lb weight gain in a
week.
DATE
WEIGHT
DATE
WEIGHT
DATE
WEIGHT
When to Call HomeChoice Partners

If your weight increases 2-3
pounds in a day or 5 pounds in a
week
If either one of your infusion
pumps malfunctions
If you notice any redness or
drainage on the skin around your
catheter
If you have any questions or
problems regarding your infusion

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CONGESTIVE HEART FAILURE

What is Heart Failure?

Fluid can accumulate in the lungs and result in

What Causes Heart Failure?

Symptoms and Treatment

The pharmacy will deliver your medication weekly

Monitoring your Weight

Salt and Fluid Restrictions

In addition to restricting your salt intake, you need to

Remember, you are the most

When to Call HomeChoice Partners

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