Congestive Heart Failure

1
Congestive Heart Failure

• Teaching Manual

2
What is CHF?

• Congestive Heart Failure describes a condition
  where the heart muscle is weakened and cannot
  pump as strongly as before.
• This means less oxygen is reaching the organs
  and muscles in your body which can make you feel
  tired and short of breath.

3
How did I get it?

• Heart attack
• High blood pressure
• Valvular disease
• Viral infection
• Alcohol
• Unknown causes

4
How would I feel?

• Short of breath
• Fluid retention in legs, belly or lungs
• Fatigue or tiredness
• Weight gain

5
Why water retention?

• Poor heart pump
• Decreased blood flow to kidneys
• Kidneys hold onto fluid and salt because they
  think the person is dry.
• Heart cant pump against all this extra fluid
• Fluid goes into legs and /or lungs

6
Did You Know?

• Salt, Sodium and MSG is the same thing.
• Sea Salt is Salt!
• Limit Salt to 2000 mg per day.

7
Where is Salt Found?

• Naturally in most foods.
• Bread, Potato, Vegetables
• Canned and Prepackaged foods.
• Spices high in Salt
• BBQ sauce, bouillon cubes, ketchup, mustard.

8
How much Salt is too much?

• Limit is 2000 mg of salt per day. This equals 1
  teaspoon of salt all day.
• Stay away from salty snacks- potato chips
  salted crackers pretzels.
• No salt shaker.

9
Salt- more information

• No canned soups, or processed foods.
• Pickled foods have too much salt. Pickles
  sauerkraut, olives, all have too much salt.

10
Reading Labels

• Always read the food label.
• How many servings in each package?
• Look for the words Salt, Sodium, MSG.

11
Reading Labels

• If Salt or Sodium or MSG are in the top five
  ingredients DO NOT EAT THE FOOD!
• This food would be too much salt for your diet.
  
• Remember 2000 mg per day.

12
Canned Soup

• All canned soup has too much salt for your diet.
  One serving of Chicken Noodle soup has 1800 mg of
  sodium. All you can have in one day is 2000 mg.

13
How much can I drink?

• Do not drink more than 1.5 litres to 2 litres of
  fluid per day.
• That equals 6-8 cups of fluid all day.

14
Kinds of Fluids

• 1 cup 250 ml 8 ounces.
• Water, milk, coffee, tea, juices are all fluids.
• Some types of pop are high in salt. Read the
  label.

15
Do Not Drink

• Stay away from Vegetable juices, Clamato juice,
  and tomato juice.
• These all have too much salt.

16
Things to Avoid

• Limit alcohol use.
• Some doctors state no alcohol.
• STOP SMOKING!

17
Daily Weights

• Weigh yourself daily.
• Use the same scale, and weigh yourself first
  thing in the morning before breakfast.
• Call the clinic if weight increases by two
  pounds overnight or five pounds in a few days.

18
Rest and Exercise

• Make exercise part of your daily routine.
• Try to take a mid day REST for 30 - 60 minutes
  per day.
• When exercising make sure you can walk and talk.
  If not, stop walking or slow down.
• Stop all exercise if you feel short of breath
  or develop chest pressure.

19
Lets keep active!

• Exercise is like a natural medication You have
  to take it regularly to maintain the benefits!
• Take advantage of your good days.
• Find a partner for exercise.
• Enjoy being active!

20
Which activities are good?

• Walking, riding a stationary bicycle, gardening,
  etc. are excellent activities to improve your
  endurance.
• 20 to 30 minutes 2-3 times per week
• Stretching improves your flexibility
• Always check with your doctor or nurse if you
  plan to increase your exercise.

21
What else should I know?

• Stop exercise if you feel short of breath or
  develop chest pressure.
• Do not exercise if
• You gained more than 1 lb from previous day
• If you feel more short of breath then usual

22
MEDICATIONS

• Remember to always take your medications at a
  regular time every day.
• Do not skip doses.
• Do not self medicate.

23
ACE Inhibitors

• This family of drugs help reduce the stress on
  the heart .
• This drug helps the kidneys open its vessels
  better, release more fluid and lower blood
  pressure.
• Examples Altace Lisinopril Monopril
  Enalapril.

24
Beta Blockers

• This drug family helps with slowing down the
  heart rate, lowering the blood pressure so that
  the heart does not have to work so hard.
• Examples Coreg Monocor Metoprolol.

25
Diurectics

• This family of drugs help the kidneys remove
  extra fluid.
• Examples Lasix Furosemide Zaroxolyn
  Metalazone Loside.

26
Aldactone

• This drug is classified as a water pill but it
  is not used for that reason.
• Research has shown that if you take a small
  dose every day, it may improve the heart function
  over time.
• With this drug you have to watch how much
  potassium you eat.

27
ARBS

• Angiotensin II receptor blockers - this family
  of drugs assist the heart and kidneys to remove
  extra fluid and reduce the blood pressure.
• Example Atacand Diovan Losartan.

28
Produced By

• Royal Alexandra Hospital, Heart Function
  Stabilization Program, Edmonton, AB
• Josephine Amelio BScN RN
• In collaboration with
• Rosa Gutierrez NP, MN
• Dagmar Knot RN CCN ( C)
• Sandra Mandic