Don't Go Breaking My Heart
How often should you weight your HF patient?
Daily
What is heart failure?
Inability of the heart to pump enough blood to meet the body's needs
What are some symptoms of left sided heart failure?
Short of breath, New cough, Fatigue, Exercise intolerance, Pulmonary congestion, Crackles, Orthopnea, Paroxysmal Nocturnal Dyspnea
How much fluid should your HF patient have in 1 day?
64 oz or about 2 L
Diuretics
If your patient can stand, should you weigh them in the bed?
No!!!
What are some risk factors for heart failure?
Smoking, obesity, physical inactivity, unhealthy diet, ETOH use, CAD, HTN, DM, CKD, thyroid disease, valvular heart disease, chronic lung disease
What is a normal ejection fraction (EF)?
50-70%
False! We want all I&Os recorded to help assess fluid status.
What should we watch for in patients receiving diuretics?
Electrolytes, kidney function, blood pressure, dizziness, fluid balance, weight, improvement in symptoms
If your patient gains __ pounds overnight or ___ pounds in one week, this could be a sign of fluid retention.
2-3 pounds overnight, 5 pounds in 1 week. Notify the provider!
True or false: heart failure is a chronic problem.
True! But can have acute exacerbations, resulting in worsening symptoms and hospitalizations
What are some symptoms of right sided HF?
Distended jugular veins, Fatigue, Feelings of fullness or lack of appetite, Weight gain, Dependent edema, Ascites
How much sodium should my HF patient typically have in a day?
2,000 mg
False! Jardiance (and other SGLT2 inhibitors), have beneficial effects in HF and can help provide additional gentle diuresis.
True or False: We cannot help patients obtain a scale at home.
False!
Social work can provide gift cards to help purchase a scale.
20-25%
True or False: my patient can only have left sided or right sided HF.
False! It is very common to have components of both. Left sided HF is the #1 cause of right sided HF.
What are some examples of salty foods?
Soups, Deli meats, Cheese, White bread, Pizza, Tomato Sauce, Ketchup
What does GDMT stand for?
Guideline Directed Medical Therapy
These are the pillars of HF therapy!
If you leave the PAS pump, tele box, 1 extra pillow, and one extra blanket on the bed, how much extra weight will this add!
???
What can you do to help prevent readmissions?
Educate your patient, including providing written materials
Ensure they have close follow up
Consider referrals to CM, SW, etc.
What test is typically used to assess HF?
Echocardiogram
Red folder, Elsevier resources, Dietician consult
What medications are considered to be the 4 Pillars in HF with reduced ejection fraction (systolic HF)?
Beta blockers, ACEi/ARB/ARNI, MRA, and SGLT2-i