Heart Failure Guide

Smoking 

what the nurse needs to know

smoking (specifically nicotine) causes blood vessels to constrict, making the heart work harder, and increasing blood pressure. it also depletes the body of oxygen, replacing it with carbon monoxide and other poisonous gases.

what the patient needs to know

  • smoking makes your heart work harder and makes your heart failure worse.
  • quitting smoking is one of the most important things you can do to improve your health.
  • get help to quit. ask your healthcare provider about medications that can help you quit smoking.
    • provide smoking cessation materials to the patient, including information about what the local Health Department provides in terms of smoking cessation programs

Follow Up care

what the nurse needs to know

heart failure can progress even if the patient’s symptoms remain the same. it is essential that patients go to the post-discharge appointment and subsequent appointments, even if they are feeling better. the goal is for them to feel as good as they can. regular visits to their healthcare provider can help that happen and help keep them out of the hospital.

treatment in the hospital stabilizes their condition. follow-up care is for on-going medical management and further teaching to help the patient learn ways to manage their condition.

what the patient needs to know

  • heart failure can progress even if your symptoms remain the same.
  • the goal is to feel as good as you can, and regular visits to your healthcare provider can help make that happen and help keep you out of the hospital.
  • keep all appointments with your healthcare provider, even when you feel well.
  • know your healthcare provider’s name and phone number.
  • take your calendar with you to your appointments and show your healthcare provider.
  • make sure you know the time and date for your first appointment with your healthcare provider before you leave the hospital.
  • if you do not have a primary care physician or if you have financial concerns, a Social Work or Care Management consult will be arranged prior to discharge.

symptoms

what the nurse needs to know

  • reinforce with patients that they need to contact their healthcare provider if they start to feel badly, and are experiencing symptoms such as:
    • unusual shortness of breath
    • swelling of extremities
    • sudden weight gain
    • increased fatigue
    • they may be experiencing a decrease in cardiac output, hypotension, renal complications, or medication side effects.

what the patient needs to know

  • call your healthcare provider if you are having a bad day (yellow dot) or feel you might be having side effects from your medicines:
    1. if you gain 2 pounds in a day or 5 pounds in a week
    2.  increase in the swelling in your ankles or legs
    3. more short of breath or new shortness of breath
    4. new need to sleep with additional pillows
    5. new need to sleep sitting up in a chair
    6. dizziness, nausea & vomiting, cramps in your legs, dry hacking cough
  • increasing tiredness call ambulance if you are having a worse day (red dot) and cannot reach your healthcare provider:
      • struggling to breathe when sitting up
      • chest pain 

Regarding the food label

  • begin by reviewing the serving size and sodium content information. see the shaded areas on the sample label to the right. the serving size for the food on this label is 5 oz. (ounces). the sodium content for that serving is 440 mg. remember that daily sodium intake should be 2000 mg or less.
  • if you eat the same size serving as the one listed on the label, then you are eating the amount of sodium that is listed.
  • but if the amount you actually eat is either larger or smaller, the amount of sodium you will be eating will also be larger or smaller. for example, if you eat a double portion of the food shown above, you will also be eating twice as much sodium as listed on the label. a 10 oz. serving of the food above would contain 880 mg of sodium. use the label when you shop, as you plan your meals, and as you cook each day. the label makes it easy to determine the amounts of nutrients you’re getting and to compare one product to another.

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