This document provides information and tips for patients to self-manage heart failure, including six key tips: 1. Take medications as prescribed and monitor for side effects. 2. Check daily weights and notify the provider of gains of 2-3 lbs in a day or 5 lbs in a week. 3. Decrease sodium intake to less than 2000 mg per day by reducing salt and processed foods. 4. Follow the recommended daily fluid limit of 6-8 cups and count high-moisture foods as fluid. 5. Find a balance of rest and gradual activity like putting feet up or taking naps between periods of exercise. 6. Monitor symptoms daily and notify the provider of new or increased

1. Created By: Nicole Wiegert, RN, BSN
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2. Learning Objectives
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After completion of this lesson, the patient will be able to:
• accurately check daily weights and assess for a three pound
weight gain in one day or five pounds in a week.
• develop a log to track daily weights, blood pressure,
symptoms and fluid and sodium intake as directed.
• reflect on the importance of monitoring their symptoms
daily and identify a tool that will guide them with symptom
monitoring.
• suggest at least one lifestyle modification that can be made
to improve their management of heart failure.

3. 3
Heart Failure Self-Management
• YOU play a key role in optimizing your heart failure treatment
outcomes.
-Adherence to self-management is necessary
• Self-management = The decisions and behaviors that patients
participate in that affect their health
The following slides will provide some basic tips for heart failure
self-management .
(Improving Chronic Illness Care, n.d.)

4. Tip #1: Take Your Medications As Prescribed
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• Keep an updated medication list, carry a copy in your wallet.
-Include: name of med, dose and how often it is taken each
day
• If your water-pill is prescribed once a day, take it in the morning.
-This may help avoid unnecessary trips to the bathroom at
night.
• Ask for refills at least one week before your meds run out.
• Report any side effects of your meds to your provider.
-i.e. dizziness, nausea, changes in sexual function
DO NOT STOP OR TAKE EXTRA MEDICATION WITHOUT
FIRST CONSULTING YOUR PROVIDER!!!
(Purcell & Fletcher, 2014)

5. Tip #2: Monitor Your Weight Daily
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• Weigh first thing in the morning.
-Use same scale
-Wear the same amount of clothing
-Weigh before eating or drinking and after urinating
• Keep a log of your daily weights.
-Take this log to your appointments.
• Notify your provider of a 2-3 lb. weight gain in one day or 5 lbs. in
7 days.
-Rapid weight gain may be a sign
of fluid build-up if your diet has not changed.
(OSU Wexner Medical Center, 2014 &
Purcell & Fletcher, 2014)
Click here to learn more
about monitoring daily
weights from OSU
Wexner Medical Center.

6. 6
Your weight yesterday when you checked it was 204 lbs. This
morning when you checked your weight it was 208 lbs.
You should:
A. Do nothing
B. Take an extra diuretic (water pill)
C. Contact your Provider
Correct Answer: C. Contact your Provider
Your provider should be contacted if you have a weight gain of 2-3 lbs. in one
day or 5 lbs. in one week. Quick weight gains are usually a sign of fluid build up.
Your provider will direct you if medication adjustments are necessary.

7. Tip #3: Decrease Your Sodium Intake
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Foods high in sodium (salt) cause the body to hold on to extra fluid.
• Ask your provider which sodium limit is best for you.
-Most patients are asked to consume less than 2,000 mg/day.
• Keep track of your sodium intake each day.
• Some ways to lower sodium in your diet include:
- Do not cook with salt, or add salt at the table
- Season foods with fresh herbs
- Choose fresh foods instead of canned or processed
- Read food and beverage labels: pay attention to sodium
content and serving sizes.
• When shopping, low sodium foods = 140 mg or less/serving size
(Purcell & Fletcher, 2014)

8. Tip #4: Follow Your Recommended Daily Fluid
Intake
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• Ask your provider how much fluid you are allowed in one day.
-Most patients are asked to limit their fluid to 6-8 cups (8oz.)
per day.
• Remember… foods that are liquid at room temperature should be
treated as fluid.
-Popsicles, soup, ice cream, Jell-O, and ice cubes
-High moisture foods may also need to be counted (grapes,
strawberries)
• Keep track of your fluid intake (mentally or written).
(Purcell & Fletcher, 2014)

9. Tip #5: Find Balance Between Rest
and Activity
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• Rest
-Put your feet up a few times throughout the day.
-Consider a nap.
• Activity
-Ask your provider about gradually increasing your
exercise.
-Choose an exercise that doesn’t make you too tired.
-Don’t lift really heavy objects: Ask your provider if you
have a lifting restriction.
• Alternate periods of activity and rest.
(Purcell & Fletcher, 2014)

10. Tip #6: Symptom Monitoring
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Daily symptom monitoring allows you to catch symptoms before they
get too serious.
• Call Your Provider if you have new onset or an increase in the
following symptoms:
-Sudden weight gain (2-3 lbs. in 1 day or 5 lbs. in 7 days)
-Shortness of breath, especially when laying down
-Swelling in ankles, legs, feet and abdomen (bloating)
-Constant cough
-Fatigue
-Dizziness or fainting
-Chest pain or pressure
View the American Heart Association’s
Self-Check Plan Here
(Self-Check Plan for HF Management, 2015 & Purcell & Fletcher, 2014)

11. 11
To help manage my heart failure I should:
B. Eat as much salt as I want.
C. Take my medications as prescribed.
D. Both A & C
Correct Answer: D. Both A &C
Some heart failure self-management tips include: take your medications as
prescribed, monitor daily weights and symptoms, decrease your sodium intake,
follow your recommended daily fluid intake and balance rest with activity.
A. Monitor my weight and symptoms on a daily basis.

12. ALSO REMEMBER…
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• Be sure to attend your scheduled follow-up appointments with
your provider.
• Lean on your family, friends and healthcare team for support.
can take control of your heart failure!
If you have questions about your treatment plan or need additional
support please speak with your provider.

13. Review: Heart Failure Self-Management
Jeopardy
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Click Here to play Heart Failure
Self-Management Jeopardy

14. References
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Improving Chronic Illness Care. (n.d.). Retrieved June 10, 2016, from
http://www.improvingchroniccare.org/index.php?p=SelfManagement_Sup
port&s=39
OSU Wexner Medical Center. (2014, June 24). Congestive Heart Failure and
Monitoring Your Weight Daily [Video file]. Retrieved from
https://www.youtube.com/watch?v=HHfcj0g1yHA
Purcell, J. A., & Fletcher, B. J. (2014). A stronger pump: A guide for people with all
types of heart failure. Atlanta, GA: Pritchett & Hull Associates.
Self-Check Plan for HF Management. (2015). Retrieved June 10, 2016 , from
http://www.heart.org/idc/groups/heartpublic/@wcm/@hcm/documents/
downloadable/ucm_477328.pdf