Date issued: June 2019
For review: June 2021
Ref: A-419/Cardiology/RG/Heart failure
You have been told you have heart failure, which means your heart is not working as effectively as it should do. This may cause you to have excess fluid in your body which can cause fatigue, breathlessness, swollen limbs, loss of appetite or a feeling of being bloated. There can be several reasons why your heart is failing to work as well as it should, and your Clinical Nurse Specialist will have explained the details of your heart function to you at the time you received this pack.
We have enclosed a Self-Management Plan for you to use once you leave hospital. This is based on you recording your weight daily and monitoring for any changes in your symptoms. Your Clinical Nurse Specialist will have explained how it is best to weigh at the same time every day. It is advisable to weigh without clothing or wearing similar clothing each time, using the same scales, with the scales in the same position and to keep a written note of your weight so you can compare the numbers daily.
If your weight increases by 2lbs or 1 kg or more in 2 consecutive days or there is a small gradual increase every day for 3-4 days, this could be an indication your body is building up fluid, which may lead to a worsening of symptoms if it is not treated. Contact your Heart Nurse or GP for advice on how to treat the fluid overload before it causes you any discomfort. If you have been advised by your Heart Nurse to self-manage your water tablets, there may be an indication to increase by one water tablet for 2-4 days to help. If your symptoms do not improve then please contact your GP or community Heart Nurse. You may need a kidney blood test if there is an alteration in your medication.
It is important to ensure you take your medications every day.
If you are unable to weigh daily, the other signs of fluid retention mentioned in the AMBER column of the management plan, are an indication that you need to either contact your GP or dedicated community Heart Nurse for advice as soon as you notice any ONE of the symptoms. Do not wait for the symptoms to improve on their own, they most likely will not, and if not acted upon early could result in you becoming unwell.
The aim of the management plan is for you to stay in the GREEN zone which describes being well and the fluid balance in your body is controlled. If you have any one of the symptoms mentioned in AMBER contact your Heart Nurse or GP for advice. This should then ensure you return to the GREEN and continue to be free from symptoms. We are hoping you do not develop any of the RED symptoms and the aim is to identify any concerns early to prevent serious deterioration in your health.
Try to limit your total fluid intake to between 3 to 4 pints or 1.5-2 litres daily, this includes all of the water, tea, coffee, milk, soft drinks and alcohol you drink every day. In the summer it will also include any ice-lollies you have and ice cubes added to your drinks. Your Clinical Nurse Specialist will advise you how much fluid is appropriate for you. Sometimes your medication is stopped or altered; this is sometimes due to your kidney function. Please ensure that your medications are reviewed regularly, especially if water tablets are reduced or stopped, for any reason as these may need to be resumed again to avoid problems with fluid build-up.
Please aim to eat foods which have a low salt content the salt will encourage your body to hold onto excess fluid. Try to avoid salt substitutes, they are high in potassium. We hope this information has been helpful.