Congestive Heart Failure

By Lynn Christain RN

According to the CDC, over five million people have heart failure in the United States, with 550 thousand new cases diagnosed each year. Over 287 thousand people will die this year as a result of congestive heart failure. The most common causes include coronary artery disease, hypertension, and diabetes.
Education of this group of individuals is vital in minimizing mortality and hospitalizations, as congestive heart failure is the most common admission diagnosis for the population using Medicare (CDC, 2009).

While and Kiek (2009), state that evidence supports that self-management programs have a positive affect on the quality of life and self care behaviors elicited by this group of individuals. In conjunction with this self-efficacy, nurse-directed patient education also plays a large role in management of this disease (2009).
As nurses, we must advocate for our patients psychological support network as many patients with CHF also have anxiety and depression. In addition, regular exercise, teaching about the patients medications and ensuring they have a clear understanding of why each medication is important is essential. Daily blood pressure and weight checks are important, as is keeping an accurate log. Identifying 1-2 pound weight gain in a 24 hour period or 3 pound weight gain in a week as warning sign and the primary health care provider should be notified. Other early warning signs that patients should be aware of are shortness of breath and difficulty lying in a flat position. All of these signs are vital to detecting fluid overload and may indicate the need for adjustment in the patient’s diuretics.
When educating a patient on their diet, emphasizing fresh fruits, meat and vegetables, and choosing foods low in salt, such as, poultry, legumes, milk, yogurt, pasta, rice and legumes, is important. Encourage patients to season with herbs, spices and fruit juices instead of salt. It is also important to teach patients to read labels and be able to identify the amount of sodium in less that 350 milligrams per serving. Another way to identify foods high in sodium is by locating the ingredients, if salt or sodium is listed in the first five ingredients, it is probably too high (UCSF, 2009).
Congestive heart failure is best managed by self-efficacy; patients must become their own advocates. In order for patients to transition into their own advocate, they must perceive their susceptibility to the disease as a serious illness and make educated choices regarding the modifiable factors that potentate the disease process such as diet, exercise, medication compliance, and follow up health visits. Often these modifiable factors are seen as barriers by CHF Patients. Education regarding how to change these modifiable factors will reduce the likelihood of exacerbations of CHF, thereby becoming more self sufficient in managing their own disease process.
It is important to acknowledge however, that each patient will differ in educational backgroupnd and cultural considerations must be made accordingly.

References
Centers for Disease Control and Prevention. Division for Heart Disease and Stroke Prevention. Retrieved from http://www.cdc.gov/dhdsp/library/fs_heart_failure.htm.

University of California. Diet and Congestive heart failure. Retrieved from http://www.ucsfhealth.org/adult/edu/dietAndHeartFailure/index.html.

While, A., & Kiek, F. (2009). Chronic heart failure: promoting quality of life. British Journal of Community Nursing, 14(2), 54-59.

Note: This blog post reflects the work of Lynn Christian RN with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.