Condition & Symptoms - Level 1
Goal: Partner with the individual to find out what they understand about CHF, including causes and symptoms.
Possible Action Steps
- Find out whether individual can simply describe CHF. Assist in a simple-to-understand description.
- Ask individual to discuss one or two symptoms of CHF. Do they know where these symptoms are “coming from?”
- Find out if the individual knows why they need to monitor their weight.
- Ask individual to record their weight at least three times in the upcoming week.
- Understand how the individual perceives the causes of CHF. Clear up misconceptions.
Supporting Resources
Goal: Build awareness of CHF’s yellow and red flags and learn how to respond.
Possible Action Steps
- Ask individual to identify any recent CHF symptoms.
- Ask individual about other symptoms they may not identify as being related to CHF.
- Discuss the CHF red and yellow flag system:
- YELLOW FLAGS: Call doctor immediately!
- Weight gain: 2 pounds in a day ~ or ~ 5 pounds over the last five days.
- Swelling of the legs, ankles, feet or stomach.
- RED FLAGS: Call 911 immediately!
- Chest pain.
- Difficulty breathing while resting.
- Cough that gets worse at night and/or when lying down.
- Review with individual what to do when a yellow or red flag symptom occurs.
Supporting Resources
Goal: Promote awareness of the language of CHF.
Possible Action Steps
- Have individual talk about his/her understanding of CHF.
- Have individual talk about words and phrases they have heard used in the discussion of CHF that they don’t fully understand.
- Together, review key CHF terms and words – e.g. dropsy, left-side/systolic heart failure, right-side/ diastolic heart failure, fluid retention, edema, EKG, BNP blood test, echocardiography, high blood pressure, good (HDL) and bad cholesterol (LDL), DASH diet, sodium, saturated fat, trans fat, diuretics, ACE inhibitors, Beta Blockers, etc.
Supporting Resources
Goal: Help individual identify what is a priority for them with regard to how they feel and function.
Possible Action Steps
- Ask individual about their life priorities.
- Discuss with individual how their life priorities conflict with how they feel and function.
- Together, identify a small action step to work toward what is important to the individual.
- Ask individual to commit to take a small action step to feel and function better.
Supporting Resources
Goal: Work with the individual to ensure that they understand the risk of weight gain, the importance of monitoring weight daily, and correct response to changes in weight.
Possible Action Steps
- Discuss the importance of managing weight in CHF.
- Talk about the importance of checking weight daily.
- Discuss the right way to check weight: check weight once each day at the same time of day.
- Discuss how to respond to sudden changes in weight: Call doctor immediately if a gain of two pounds in a day or five pounds over the last five days (yellow flags).
- Develop a plan to measure weight and track daily results.
Supporting Resources
Goal: Help the individual get more help and support out of interactions with healthcare providers, family, and friends.
Possible Action Steps
- Identify key member on the individual’s team – doctor, nurse, spouse, partner, family member, friend, neighbor, etc.
- Discuss how to best use a loved one or close friend for support.
- Together, role-play to help individual feel comfortable asking questions to a healthcare provider.
- Ensure that all necessary appointments are scheduled.
- Discuss whether the individual has transportation to get to clinic appointments.
Supporting Resources
Goal: Build awareness about the danger of smoking with CHF.
Possible Action Steps
- Discuss how smoking and other tobacco products contribute to making CHF worse.
- Discuss how second hand smoke negatively impacts CHF.
- Ask individual to talk about their daily exposure to second hand smoke.
Supporting Resources
- See CHF Smoking Cessation Section.