What is heart failure?

Heart failure is commonly known as "poor heart pumping." It refers to a disorder of cardiac structure or function, causing insufficient cardiac output for body requirement. This disease requires continuous treatment and persistent care.

What are symptoms of heart failure?

When the heart failure patients intake too much fluids and the heart can not keep up with its workload. The accumulation of excess fluid can lead weight gain. When the heart fails to pump blood efficiently to the kidneys and the kidneys are unable to produce urine. The symptoms may include decreased urine output, oliguria and nocturia. The excessive fluid would build up in different parts of the body, leading to ankles or low legs edema, headache, and nausea. Moreover, fluid may back up in the lungs causing dyspnea, orthopnea, and shortness of breath that occurs at night, cough, fatigue and weakness. Thus, it is important to control the fluid intake for heart-failure patients.

What can I do to prevent fluid overload?

To limit fluid intake can reduce your heart workload. Avoid the fluid overload to prevent swelling, pulmonary effusion and hospital admission. The amount of fluid intake should be controlled around 1,500 to 1,800 c.c. a day for heart failure patients. Clinically, strict fluid restriction may be needed depends on patients’ condition. Daily Water Intake =Total Output of the day before (including urine, vomiting, defecation volume or drainage)+ 500 ~ 700 cc.

1. At the beginning of the day, you should put the appropriate amount of water into bottles according to your daily needs. The amount of water can include your daily drinking water, beverages, and soup, other foods that contain fluid, or nasogastric tube feeding or nutritional drinks, and intravenous fluid.
2. Keys to manage your fluid：Avoid processed food with additives as they can make you thirsty. Have low salt diet. Cooking with vegetable oil and you could season your food with onion and/or garlic to increase flavor. When you feel thirsty, you can use cotton swab or lip balm to keep your lips moist. Suck on sugar-free candy or chew sugar-free gum or suck on ice-cubes until it slowly melt.
3. Recommendation for fluid intake distribution per day: 7 a.m.to 3 p.m.: 50%; 3 p.m.to 11 p.m.: 40%; 11 p.m.to next day 7 a.m.:10%. For example, fluid restriction 1500 ml/day, 7 a.m.to3 p.m. take 750 ml; 3 p.m. to 11 p.m. take 600 ml; 11 p.m. to next day 7 a.m. take 150 ml.
4. Weighing yourself when you first get up in the morning. The right way to weigh in：Weigh yourself after you urinate, wearing the same amount of clothing and write down your weight every day. Bring the records to your doctor at OPD. If you gain 1 kg in1 day or more than 2 kg in 3 days and occur the shortness of breath, chronic cough and peripheral edema, please return to the hospital right away.
5. Always use a urinal bottle with scale to measure the amount of urine.

References

1. Chen, S.Y., Wang, Y.H., Lin, W.H., Tsou, L. F., Chen, S.H., & Lin, S. Y. (2017).Effect of applying evidence-based protocol to reduce thirst distress in heart failure patients. The Kaohsiung Journal of Nursing, 34(1), 1-11. http://doi.org/10.6692/KJN-2017-34-1-1
2. Abdo, A. S. (2017). Hospital management of acute decompensated heart failure. The American Journal of the Medical Sciences, 353(3), 265-274. http://doi.org/10.1016/j.amjms.2016.08.026
3. Johansson, P.,van der Wal, M. H., Strömberg, A., Waldreus, N., & Jaarsma, T. (2016). Fluid restriction in patients with heart failure: how should we think?. European Journal of Cardiovascular Nursing, 15(5),301-304. http://doi.org/10.1177/1474515116650346
4. Rong, X., Peng, Y., Yu, H. P., & Li, D. (2017). Cultural factors influencing dietary and fluid restriction behavior: perceptions of older Chinese patients with heart failure. Journal of Clinical Nursing, 26(5-6), 717-726. http://doi.org/10.1111/jocn.13515