Running head: NUTRITION ASSESSMENT

Nutrition Assessment on Congestive Heart Failure

Krista Caprio
University of South Florida

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Nutrition assessment on Congestive Heart failure

It was a Monday afternoon and I had just gotten the orders from the Doctor that my
patient, Mrs. Johnson, was to be discharged. Mrs. Johnson has just been diagnosed with
Congestive Heart Failure and has been prescribed an oral diuretic. I walked into Mrs. Johnson
room to tell her that she would be leaving that day, I took out her IV, and told her to get her
things together and that I would be back for discharge.
I returned to Mrs. Johnsons room later with a bundle of information. Since Mrs. Johnson
has been diagnosed with Congestive Heart Failure I knew I would have to do some patient
teaching concerning her diet, as well as, Mrs. Johnson would have to make some changes to her
current diet in order to prevent the worsening of her newly diagnosed condition. I printed out a
packet of information for her so she would be able to review it at home as well as discuss it with
me and ask any questions during discharge. Mrs. Johnson did not seem too clear on the
explanation the doctor gave her on her diagnosis, so I proceeded to explain to her that the heart is
weakened in Congestive Heart Failure, because the heart does not pump as strongly there is a
backup of blood in the heart. This build- up of blood forces the fluid in the blood into the lungs
this would cause symptom such as shortness of breath or edema is the lower extremities. Sodium
acts like a sponge and holds excess water which will create more work for the heart which we
dont want, thus reducing sodium in the diet is an important part of therapy for Cardiac Failure
(Group Health, 2014, p.1). Since Ms. Johnson is also on an oral diuretic to maintain fluid balance
I explained to her that she will need to take a Thiamin supplement from a multivitamin. This is
because Thiamin is lost in urine due to the diuretic and the deficiency of Thiamin causes heart
failure like symptoms (Osborn, 2010, p. 178).
Mrs. Johnson did not know the types of food that were high in sodium nor what she
should evade from her diet, so I then expounded upon the type of foods that would and would
not be appropriate. Processed, preserved, and convenience foods are high in sodium, and

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anything ready-to-eat will have a high sodium content. Plain or fresh forms of food have low
sodium content such as fresh fruit, vegetables, plain grains, fish, and milk. I also recommended
watching out for certain labels, because foods labeled reduced sodium only have 25% less
sodium than the original, but foods with labels that say low sodium will have 140mg of
sodium or less per serving and you should try to limit sodium to 2 grams, or 2000 milligrams per
day (Osborn, 2010, p. 175 & 178). Some tips I gave Mrs. Johnson to make adjusting to the new
diet a little easier was to remove the salt shaker from the kitchen, that way she will be less likely
to use it, and to use spices and herbs to season food for flavor rather than salt. She should also
limit excessive intake of fluids and alcohol. Caffeine should also be avoided because it can cause
increased or irregular heartbeats since it is a stimulant (Group Health, 2014, p. 1). I expressed to
Mrs. Johnson that it was extremely important to meet her nutritional needs and that if they
continually are unmet and muscle and fat wasting ensue it can cause Cardiac Cachexia which is
advanced Cardiac Failure (Osborn, 2010, p. 178).
By the time of discharge Mrs. Johnson expressed that she was comfortable with the
information she was given concerning her diet and was able to teach back to me what was
learned. She stated that she would read over her packet if she needed a reminder or call her
primary care physician.

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References
Group Health Cooperative. (2014). Nutrition Tips for Congestive Heart Failure. Retrieved from
http://www.ghc.org/healthAndWellness/?
item=/common/healthAndWellness/conditions/heartDisease/chfNutrition.html
Osborn, K. S., Wraa, C. E., Watson, A., & Holleran, R. S. (2010). Nutrition. In Medical Surgical
Nursing: Preparation for Practice (2nd ed., pp. 175,178). Julie Levin Alexander.