Condition & Symptoms - Level 2
Goal: Continue to build CHF knowledge: understanding of CHF causes, risk factors, yellow & red flag symptoms & responses, and key numbers for blood pressure, weight, and cholesterol.
Possible Action Steps
- Discuss the causes and risk factors for CHF. Help individual to identify his/her risk factors.
- Review the CHF yellow and red 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.
- YELLOW FLAGS: Call doctor immediately!
- Chest pain.
- Difficulty breathing while resting.
- Cough that gets worse at night and/or when lying down.
- Encourage individual to keep a diary to keep track of when fluid build-up symptoms occur.
- Discuss the individual’s most recent key numbers for blood pressure, weight, and cholesterol.
- Together, compare individual’s key numbers (blood pressure, weight, cholesterol) to targets set by their physician.
Supporting Resources
Goal: Have the patient identify what is a priority for them with regard to how they feel and function.
Possible Action Steps
- Work with individual to choose a small action step to work toward what is important to the individual.
- Problem solve together about how to work this small step into their daily life.
- Ask individual to commit to taking a small action step in the upcoming week.
Supporting Resources
Goal: Work with the individual to ensure that they understand the importance of checking their weight daily, how to do so properly, and how to respond to changes in weight.
Possible Action Steps
- Discuss the importance of checking weight daily.
- Find out if the individual knows how to check their weight properly -- once each day at the same time each day.
- Discuss when the individual should be concerned about CHF related weight gain.
- Discuss how to respond to CHF related changes in weight.
- Together, develop a plan to correctly measure weight and track daily results.
Supporting Resources
Goal: Continue to instill the importance of key behaviors to better control CHF. Work on one achievable small step change.
Possible Action Steps
- Together, review individual’s actual numbers and key targets for blood pressure, daily mg/salt intake, & weight.
- Discuss the benefits of daily weighing and review what should be done if weight jumps up suddenly, or overnight.
- Have individual take notice when fluid build-up symptoms occur.
- Have individual take notice when adjustments in self-care (less salt, medications, elevate head of bed) result in a reduction in fluid build-up symptoms.
- Work together to identify one or two small-step changes. Options to consider:
- Reduce smoking or other tobacco use with a plan to quit (see smoking section).
- Reduce alcohol consumption with a plan to eliminate (see nutrition section).
- Reduce sodium/salt intake to <1500 mg sodium daily (see nutrition section).
- Elevate head of the bed.
- Pay better attention to medication schedule.
Supporting Resources
Goal: Help individual understand how the flu, colds and pneumonia can exacerbate CHF. Learn how to reduce risk for these acute illnesses.
Possible Action Steps
- Discuss the warning signs for the cold, including signs that a cold is worsening.
- Discuss the warning signs for the flu and pneumonia.
- Discuss the importance of vaccinations to help prevent the flu and pneumonia.
- Together, make a plan how the individual can get immunized for flu and pneumonia if they haven’t done so already.
Supporting Resources
Goal: Start to make a small step change to eliminate or reduce
smoking/tobacco/e-cigarette use.
Possible Action Steps
- Find out what the individual already knows about how smoking/tobacco/e-cigarettes contribute to making CHF worse.
- Ask individual if they understand how second hand smoke or e-cigarettes might negatively impact CHF.
- Ask individual to talk about their daily exposure to second hand smoke and/or air pollution and identify a way to reduce exposure.
- Have the individual identify a small step change to begin the process of cutting back on smoking/tobacco/e-cigarettes and/or reducing exposure to smoke/air pollution.
Supporting Resources
- See CHF Smoking Cessation Section.
Goal: Develop awareness of healthy lifestyle guidelines for CHF.
Possible Action Steps
- Help individual to become aware of recommended daily activity levels for CHF (suggest working up to 10,000 steps or 30 minutes of moderate activity per day.)
- Help individual to become aware of ideal and actual BMI, weight, and waist measurements.
- Help individual to become aware of dietary recommendations for CHF.
- Be aware of appropriate food serving sizes for optimal heart health.
Supporting Resources