Congestive Heart Failure

This booklet has been written to answer questions that many patients and family members ask about their care during their hospital stay. It will explain the experiences you will have while you are here. Using this as a guide, your care will be adapted to your needs. When being treated for just Congestive Heart Failure, your length of stay may be about 4 days. You may stay a shorter or longer time, depending on many factors.
Remember, this is a guide Specific care and timing will be adjusted to you.

Guide to MEETINGS in the Hospital
Someone from Respiratory Care will come to your room to talk about your breathing and evaluate your oxygen needs. They will see you every day.
A Nutrition Supervisor or Dietician will come to talk with you about your food preferences and patterns, answer questions you may have, and help you learn to about low sodium foods.
A Pharmacist will talk with you about your medications, how to take each one, and what to expect from each one.
A Discharge Planning nurse will help you with any help you may need after you leave the hospital.
The second day you are here you will have a visit by a Physical Therapist to evaluate any needs you may have. He or she will work with you to increase activity without making your symptoms worse, and will also help you to set up a home exercise program.

Guide to ACTIVITY in the Hospital
How much you do will depend on your comfort with breathing and your oxygen level as measured by the oximeter.
The physical therapist will work with you on learning to balance your activity and rest. When able, you will start by walking twice on the unit as well as to the bathroom on the first day.
On the 2nd day you will walk 2-3 times and practice stepping on and off a 6 inch step. Someone from physical therapy will work with you on a home exercise plan.
Your main goal the last two days you are here will be to prepare to go home.

Guide to NUTRITION in the Hospital
Your diet will depend on your condition. You may start on liquids if you are very sort of breath, and then advance to solid foods. You will be encouraged to eat 6 small meals per day. A nurse or nutrition supervisor can help you make out the menu for each day, using a 2gram sodium limit. The sodium restriction will help prevent your body from retaining excess fluid. Your doctor may also want to limit how much fluid you drink.

Guide to TREATMENTS in the Hospital
IV
Fluids and medicines may be given to you through an intravenous catheter, or IV. The IV tubing may be disconnected so that you can move around more freely. The IV catheter will be removed the day you go home.

Intake & Output
While you are here the nurse will measure the amount of fluids you drink and will also measure your urine. You may have a Foley catheter put into your bladder to drain your urine. If you have a Foley catheter, it will be removed and we will make sure you urinate before you go home.

Vital signs
You will be weighed you arrive and every day in the early morning. Your temperature, blood pressure, pulse, and rate of breathing will be checked every 4 to 8 hours or more often if needed. The doctor and nurse will listen to your heart and lungs every day. You may wear a portable telemetry unit so that your heart rhythm can be watched as you go about your activities.

Oximeter
A clip or wrap will be placed on your finger or earlobe to check the oxygen level in your blood. This will be checked regularly to help decide your oxygen needs. It will help determine if you need oxygen and how much. This will be removed before you go home.

Guide to TESTS in the hospital
Lab tests will be ordered by your doctor. A laboratory technician will draw blood for some of these tests. The first day you are here, your nurse will send a urine sample to the lab. You will also have a chest xray, electrocardiogram (EKG), and perhaps an echocardiogram the first day.
You will probably have more lab tests, an EKG and chest xray the 2nd and 3rd days you are here.

Guide to MEDICINE in the Hospital
You will be given a diuretic to help your body eliminate extra fluids, and medicines to help your heart work better as a pump. You may also have medicines available to help reduce anxiety or pain, and something to help you sleep. Please let your nurses know how you are feeling. The day before you are discharged, your doctor will be making decisions about your medicines for home. The pharmacist will be available to talk with you about what you will be taking at home. Be sure you understand what you will be taking at home. If you would like more information about your medicine, tell your nurse.

Guide to LEARNING in the Hospital
Please help us by sharing what you know about congestive heart failure and how you manage at home. We will need to know whether you have a home scale and are able to use it, or if you would be able to get one. You will receive a packet of information to use here and to take home with you. You will learn about this condition and how you can manage it when you leave the hospital.
We will review with you what congestive heart failure is, what causes the symptoms you have had, and what other symptoms you might experience. To help you with this, we have four short videos about Congestive Heart Failure for you to watch while you are in the hospital. Every day you are here you will be offered the chance to watch the videos on congestive heart failure. Please ask questions if you don't understand something.
While you are here you will learn about your medicines and healthy food choices for a 2 gram sodium diet. It will be important to weigh yourself every day after you leave the hospital. You will learn about the record sheets we have for you to use to record your weights. Please take your weight records to your doctor appointments. It will be important for you to learn what symptoms and signs you should report to your doctor and when to call for questions.
On the day you leave the hospital, we want to be sure you understand the discharge instructions from you doctor and your plan of care for home, including when to call your doctor and when your next appointment is scheduled. Your nurse, doctor, and/or a pharmacist will review your medicines for home. If you have any questions, do not hesitate to ask. Share any concerns you may have so that we can make the move from the hospital to home easy and less stressful.
After you have gone home, a nurse may call you to check on how you are managing and answer any questions you may have.

We hope your stay has gone smoothly, that you received the care you needed, and that you have everything for your return home.
Best wishes for a speedy recovery!

Booklet compliments of the CHF Care Map Team
Patient & Family Education Council 9/2000

DAILY WEIGHT
Follow these instructions:
Weigh yourself at the same time each day. In the morning before breakfast is the best time.
Wear the same amount of clothing each time.
Empty your bladder before weighing.
Use the same scale each time.
Adjust the scale to the "zero point" each time.
If you use a spring type scale, put it on a hard surface, as carpeting may cause it to give wrong number.
Keep a written record of your weights on the back of this sheet and bring it with you to each doctor visit.
Call your doctor if your weight increases 2-3 pounds over a week

Weight / Symptom
Record Month:__________

Take with you to all doctor appointments

Weigh each day: Check boxes that apply to you each day: