LIVING WITH CONGESTIVE HEART FAILURE CHF PATIENT EDUCATION MANUAL

Living with Congestive Heart FailureTable of Contents Signs and symptoms of Heart Failure 2... Left Atrium Right AtriumYOUR HEART is a muscle that pumps blood throughout your body to sup

LIVING WITH CONGESTIVE HEART FAILURE

CHF PATIENT EDUCATION MANUAL

Patient’s Name PMD # _

Kaleida Health

CONGESTIVE HEART FAILURE

PATIENT EDUCATION MANUAL

We hope to help you learn more about CHF, help you manage your condition and maintain your optimal level of wellness

We look forward to working with you to help you take good care of your heart

CHF Care Team(Your Doctor, Nurse Practitioner (NP), Nurses, Cardiac Rehab, Dietary, Pharmacy, Patient Management Coordinators, Social Work, and Homecare Staff)

Living with Congestive Heart Failure

Table of Contents

Signs and symptoms of Heart Failure 2

Left Atrium Right Atrium

YOUR HEART is a muscle that pumps blood throughout your body to

supply your cells with oxygen Four chambers hold the blood as it moves through the heart The upper chambers are called atria and the lower

chambers are called ventricles The heart muscle pumps blood from

chamber to chamber The heart also has four valves, which act like

one way doors, separating the chambers and keeping the blood moving forward Valves open to let blood through and close to keep it from moving backward

The right side of the heart pumps blood to the lungs In the lungs, blood receives oxygen The oxygen rich blood travels back to the left side of the heart, where it is pumped to your body After your body uses up the

oxygen in the blood, it sends the blood back to the right side of the heart and the process starts again

To Body

What is heart failure

 Occurs when the heart loses its pumping or squeezing power

 Because the heart is not pumping or squeezing blood properly, the blood backs up into the lungs and other body parts, making it more difficult to do things that were easy for you to do in the past, such as walking, carrying groceries, or climbing stairs

What causes heart failure

 Weakness of the heart muscle can occur as a result of damage from a heart attack, aninfection, excessive alcohol intake, or the cause may be unknown

 High blood pressure causes the heart to work harder to pump blood out to the rest of the body

 Problems with the heart valves

 Irregular heart beat

Signs and symptoms of heart failure (CHF)

 Shortness of breath - particularly with activity or when lying flat

 Swelling of feet or legs This swelling can extend up to the waist/abdomen Thisswelling is known as edema

 Waking up at night coughing or breathless

 Tiredness or weakness, fatigue all the time

 Decrease in urination or frequently having to urinate during the night

 Weight gain - usually sudden, 3 lbs per day, or 5 lbs or more over a week

 Loss of appetite and feeling full or bloated most of the time

 Dry, constant cough which may worsen at night

Your Doctor/NP can treat many of these symptoms in the early stages, as an outpatient

If left untreated, however, they can result in admission to the hospital

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Daily weight monitoring is crucial in maintaining control of congestive

heart failure.

 Weigh yourself at the same time every day, in the same amount of clothing, on thesame scale Be sure the scale is on a flat, hard surface Weigh yourself first thing inthe morning before you eat or drink anything and after urinating

 Record your weight, daily, in a notebook

 Call your Doctor/NP if you experience a weight gain of 3 lbs or more in 24 hours or

5 lbs or more over a week or if your weight gain is higher than the amount yourDoctor/NP has decided for you

BE SURE TO WEIGH YOURSELF AND RECORD YOUR

WEIGHT EVERY DAY.

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WEIGHT RECORD & CONDITION CONGESTIVE HEART FAILURE

Keeping track of your weight is one way to determine if your heart is able to do its work If the heart isn’t pumping properly, fluid begins to collect in the body and there will be an increase in weight.

You should weigh yourself every day at the same time (in the morning after you have urinated, before you eat breakfast) and with the same amount of clothes on Call your Doctor or Nurse if you gain more than three pounds in one day Record your weight daily and any signs and symptoms you are having.

MONTH MONTH MONTH

DATE TIME WT COMMENTS DATE TIME WT COMMENTS DATE TIME WT COMMENTS

Instructions:

Call Dr if weight is lbs above dry weight.

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YOU MAY HAVE SOME OF THESE TESTS TO HELP YOUR DOCTOR TO

KNOW HOW YOUR HEART IS WORKING

determines how well your heart muscle is pumping and whether any abnormalities of the heart valves exist

activity of your heart and determines ifyou have had a heart attack, are having a heart attack or are experiencing irregular and potentially dangerous heartbeats

of material into your blood and a machine measures how effectively your heart muscle is pumping your blood through yourbody

determine the existence or extent of blockage in your coronary arteries

BLOOD TESTS FOR

ELECTROLYTES AND

ENZYMES

Blood tests that determine if you have had

a heart attack; will also tell if certain chemicals in your body are being effected

by your medications

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Medications play a very important part in managing your CHF.

How to make the most of your medications

 Keep a schedule, write down the amount of medication and the time you need to takeeach of your medications It is often helpful to use a pill organizer

 Store all medications in their original labeled containers; away from heat, light andmoisture, unless directed otherwise

 It is important to learn what each medication does and what it looks like

 It is important that your Doctor/NP knows all the medications you are takingincluding over the counter medications, home remedies, as well as prescriptionmedications

 Make sure you have enough medications Don’t run out of your medications

 Carry a list of your medications(name of medication, dose and times taken) in yourwallet or purse Always bring this list with you to Doctor’s appointments

 Do NOT double up on medications if you miss a dose, unless your Doctor/NP

instructs you to take more medications

 Take ALL of your medications

 Do NOT skip medications unless ordered by your Doctor/NP If you miss a dose, do not take it with the next dose!

 Don’t be afraid to call your Doctor, Nurse Practitioner or Pharmacist if you havequestions

PLEASE REMEMBER TO KEEP ALL MEDICATIONS AWAY

FROM CHILDREN.

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These are five types of drugs that are common in treating heart failure These improve the function of your heart.

1 ACE inhibitors/Vasodilators _

Name of the drug you are on

 This type of pill helps the blood vessels relax When these vessels are relaxed, there

is less strain on the heart and it can move the blood easier This also helps todecrease the amount of blood that returns to the heart so the heart doesn’t have towork as hard

 Call your Doctor/NP if you have any of the following side effects: weakness,dizziness, cough, or skin rash Contact your Doctor/NP immediately if you haveany: swelling of face, lips, eyes or tongue; or difficulty swallowing or breathing

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2 Diuretics(water pills)

Name of the drug you are on

 This type of pill helps your body to get rid of extra fluid The pills will cause you tourinate more When you get rid of this extra fluid, you will be able to breathe betterand your feet/legs will not be as swollen

 Remember to stay close to a bathroom for approximately 1 hour after you take yourmedication in case you should have to urinate

 Call your Doctor/NP if you have any of the following side effects: dizziness,increasing weakness, leg cramps; if you are not urinating after you take your pill, ifyou feel short of breath, if your feet/legs are still swollen

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3 Potassium

 This is a mineral that your body needs to function at its highest level When you takewater pills, you will lose more of this mineral because you are urinating more Ifyour potassium gets too low, you may experience leg cramps

 An easy way to increase your potassium level is to add extra foods that providepotassium naturally, such as bananas, dried apricots, oranges, and spinach If thisdoesn’t keep your potassium blood level high enough, the Doctor/NP may prescribe

a potassium pill for you

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4 Digoxin/Lanoxin

 Helps the heart beat stronger by improving the heart’s strength

 Be sure to take this only as your Doctor/NP has ordered it for you

 Call your Doctor/NP if you have any of the following side effects: loss of appetite,bad taste in your mouth, nausea, change in colors(things begin to look blue oryellow), your heart skipping beats, beating faster or slower than normal

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5 Beta Blockers

Name of the drug you are on

 This type of pill slows your heart rate and allows your heart to pump blood moreeffectively

 Your Doctor/NP may ask you to check your pulse before each dose of thismedication Your Doctor/NP will tell you the low to high pulse range that is okayfor you If your pulse becomes much slower or faster than usual, call yourDoctor/NP

 Do not stop taking this medication suddenly When the Doctor/NP wants to stop thisdrug, you may need to stop gradually by taking smaller doses before completelystopping the medication

 Call your Doctor/NP if you have any of the following side effects: dizziness,increased shortness of breath or rash

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For other heart or health problems, your Doctor/NP may order additional medications Some additional types of drugs are:

Antihypertensive can help lower blood pressure There are many different types of

antihypertensives that work in a variety of ways Some of the medications that treatCHF also help lower blood pressure

Antiarrhythmics are used to help control a rapid or irregular heartbeat They help keep

the heartbeat steady

Anticoagulants help prevent blood clots, which can cause a heart attack or stroke.

Anticoagulants are often prescribed for people with certain valve problems, for peoplewho have had valve surgery, or for some types of abnormal heartbeats

How to use your Medicine Record

Use the Medicine Record to keep track of what medicines to take everyday and when to take them Write the name and dose (amount) of the medicines, use the label on your medicine container for this information, and then, put a check in the box corresponding to the times of the day you are to take them.

The best way to make sure you take them correctly is to use a system Some people use a pill organizer which can have multiple areas for each day of the week The organizer can be filled weekly Some people may need to have someone else fill it for them Another system is an electronic pill reminder which can be set to beep when it is time for the next dose of medicine Some people find it best to write down each time they take a dose of medicine.

Whichever method you choose, it is best to follow it faithfully This will insure that you take all the medicines as your Doctor/NP prescribed and reduce the likelihood of errors.

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Medication Record

Name

Date Medication and Dose Brkfst Lun Din Bed

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YOUR DIET

Making healthy food choices and eating a well-balanced diet can make you

feel better Your Doctor/NP will probably recommend that you limit the amount of sodium (salt) in your diet Sodium makes the body hold on to water and can cause fluid to build up.

SALT AND SODIUM

Sodium is the major ingredient in table salt, so the first step is to take the salt shaker off of your table The next step is to avoid foods that contain large amounts of sodium

The following foods contain a large amount of sodium and should be avoided:

 prepared meats such as hot  boxed foods and dinners

dogs,bologna, salami, and  ham, bacon, and sausage

other cold cuts  cheese and cheese spreads

 canned soups and vegetables  catsup, mustard, barbecue sauce,

 canned or bottled tomato Worcestershire sauce, and soy

sauce and vegetable juices sauce

 pickles, olives and sauerkraut  peanut butter

 most “fast food”  onion salt, garlic salt, and celery

 most frozen dinners  snack foods such as potato chips,

pretzels, nacho chips and crackers

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There may be hidden sodium in other foods Get into the habit of reading labels If sodium is listed as one of the first three ingredients,

stay away from the food, there’s too much sodium in it!

Your Doctor/NP has prescribed a _diet for you.

EXAMPLES OF HOW TO CHANGE HIGH SODIUM TO LOW SODIUM CONTENT MEAL

HIGH SODIUM MEAL LOW SODIUM MEAL

BOWL OF SOUP (8OZ.) 800MG.

KRAFT MACARONI /CHEESE 800MG.

BREAD/MARGARINE(1 SLICE) 125MG.

TOTAL SODIUM (SALT) 2650MG

BOWL OF LOW SODIUM SOUP (8OZ.) 77MG SALAD WITH LOW SODIUM DRESSING 22MG.

HAMBURGER ROLL 241MG MILK (8OZ.) 125MG JELLO

BANANA 1MG TOMATO SLICE 1MG ONION 1MG.

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How to add more flavor to your foods

It takes a while to enjoy the taste of foods without salt Don't give up! Your taste budswill adjust within 3 to 4 weeks, and you will begin to enjoy the natural flavor of thefoods You can also use the following herbs and spices to season your foods Becreative and give them a try!

 Garlic and garlic powder

 onion and onion powder

CHOLESTEROL AND FATS

Your Doctor/NP may advise you to limit the amount of cholesterol, fat and especiallysaturated fat in your diet Limit eating animal fats such as the fat in meats, eggs, cheese,milk and butter as they all contain cholesterol and saturated fat Your dietitian will beable to assist you in making food choices that will help you limit the amount ofcholesterol and fat in your diet Ask to see the dietician

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Certain medications, such as diuretics (water pills), can cause potassium to leave the

body Ask your Nurse, Doctor/NP or a Dietitian if you need to eat foods that are high in potassium (to make up for losses due to medications) The following foods

are good sources of potassium:

*prune juice *baked or broiled potato *sweet potato

*nectarines *dried apricots

FLUID

Your Doctor/NP may advise you to limit the amount of fluid that you drink each day.This includes all types of fluids, including the fluid taken with medications If you arethirsty, you should try using small amounts of sugar-free hard candy to help with the drymouth Here are some examples of foods and liquids that should be counted as part ofyour fluid restriction:

*coffee and tea

Alcoholic beverages should be avoided If you do drink alcoholic beverages, you may have to stop or limit yourself to one drink per day.

**Follow your diet closely! (Cheating is a common cause of worsening CHF and often leads to readmission to the hospital).

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TO HELP YOU MEASURE:

Your Doctor/NP has prescribed a _ oz fluid restriction for you.

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