Discharge Planning Project Zamith 1

Congestive Heart Failure Discharge Planning

Jeanne Zamith, SN

University of South Florida

Discharge Planning Project Zamith 2

Congestive Heart Failure Discharge Planning

Mrs. Leia Organa has been newly diagnosed with Congestive Heart Failure (CHF) and has

been prescribed an oral diuretic. As the nurse, it is important to educate LO about the foods permitted

and restricted with this disease and discuss other ways to manage CHF.

Disease Process of Congestive Heart Failure

Congestive Heart Failure (CHF) is a disease in which there is ineffective pumping of the

heart (Apple 2010). This ineffectiveness causes the heart to become unable to generate an adequate

cardiac output to perfuse vital tissues (Huether and McCance 2008). Thus, organs, more specifically

the kidneys, are unable to function as they should. The kidneys become unable to remove excess

fluid in the form of urine, which leads to fluid overload in the bloodstream and other vital organs

(Adult Advisor 2016). Many times, physicians prescribe diuretics to control volume overload and

subsequent worsening in LV [left ventricular] function (Goodman and Gilwin 2015).

Required Nutritional Items and Rationale

Considering nutrients are not being efficiently distributed throughout the body in patients

with CHF, it is important to maintain a diet with as many nutrient-dense foods as possible. According

to The American Heart Association (AHA), this type of diet would emphasize a variety of fruits and

vegetables, whole grains, low-fat dairy products, skinless poultry and fish, nuts and legumes, and

non-tropical vegetable (2015a). Even though patients may be consuming large amounts of food, the

food consumed most likely does not have the proper nutrients to allow the body to function at its

best. Thus, these types of foods may help control weight, cholesterol, and blood pressure (AHA

2015a).

Restricted Nutritional Items and Rationale

Though many foods are permitted, and even required, with CHF patients, some foods that are

restricted include foods that are high in sodium, trans fat, and saturated fat. Some examples of these

types of food are: doughnuts, cakes, frozen pizza, canned foods, cookies, biscuits, and soda (AHA
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2015b). As stated previously, CHF causes decrease blood flow to the kidneys. As a response, the

kidneys will over-stimulate activation of the RAAS system because it reacts as if the body were

deficient in fluids, and, therefore, over-secretion of aldosterone will cause excess sodium and fluid

retention (Goodman and Gilman 2015). Therefore, it is important for patients with CHF to follow a

diet that is low in sodium to prevent edema and even respiratory depression due to excess fluid

accumulation.

Secondly, trans fats raise bad cholesterol levels and lower good cholesterol levels; thus,

both trans fats and saturated fats increase vascular resistance, resulting in an increase in cardiac

workload (AHA 2015b).

Patient Education Regarding Proper Nutrition

Though certain food may seem innocent with low-sodium labels on its packaging, it is

important to examine the actual amount of sodium intake there would be in one serving by

understanding the nutrition label. To lower blood pressure, patients with CHF should eat no more

than 2,400 mg of sodium per day (AHA 2015a). To limit the amount of saturated and trans fat

intake, a patient could choose poultry or fish without skin or look for the leanest cuts available and

avoid foods as mentioned above (AHA 2015a).

Conclusion

It is important that upon discharge, LO consume foods that are nutrient-dense rather than

foods that are high in sodium, trans fat, and saturated fat in order to maintains a healthy lifestyle to

manage Congestive Heart Failure. Patient should balance this diet along with cardiovascular exercise

and, if she is currently smoking, cessation of smoking to increase tissue perfusion as much as

possible.
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References

Adult Advisor. (2016). Patient Education Handouts - Heart Failure. Retrieved November, 2016,

from

http://accessmedicine.mhmedical.com.ezproxy.hsc.usf.edu/patientEdHandouts.aspx?gbos

ID=250279

Apple, F. S. (2010). Laboratory medicine: The diagnosis of disease in the clinical laboratory.

New York: Lange Medical Book.

Goodman, L. S., & Gilman, A. (2015). Goodman & Gilman's The Pharmacological Basis of

Therapeutics (12th ed.). New York.

The American Heart Association's Diet and Lifestyle Recommendations. (2015a, August).

Retrieved November, 2016, from

http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/The-American-

Heart-Associations-Diet-and-Lifestyle-

Recommendations_UCM_305855_Article.jsp#.WB0r_-ErKqQ

Trans Fats. (2015b, October 7). Retrieved November, 2016, from

http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/Trans-

Fats_UCM_301120_Article.jsp#.WB1CI-ErKqQ

Treas, L. S., & Wilkinson, J. M. (2014). Basic Nursing: Concepts, Skills, and Reasoning.

Philadelphia, PA: F.A Davis Company, 652.