Question

M.G., a "frequent flier," is admitted to the emergency department (ED) with a diagnosis of heart failure (HF). She was discharged from the hospital 10 days ago and comes in today stating, "I just had to come to the hospital today because I can't catch my breath and my legs are as big as tree trunks." After further questioning, you learn that she is strictly following the fluid and salt restriction ordered during her last hospital admission. She reports gaining 1 to 2 pounds every day since her discharge.

What error in teaching most likely occurred when M.G. was discharged 10 days ago?

Answer 1

M.G. may not have been counselled properly on other non-pharmacological measures for the management of heart failure, exercise included.

Explanation: Non-pharmacological measures for the management of heart failure :

• Compliance—give careful advice about disease, treatment, and self help strategies
• Diet—ensure adequate general nutrition and, in obese patients, weight reduction
• Salt—advise patients to avoid high salt content foods and not to add salt (particularly in severe cases of congestive heart failure)
• Fluid—urge overloaded patients and those with severe congestive heart failure to restrict their fluid intake
• Alcohol—advise moderate alcohol consumption (abstinence in alcohol related cardiomyopathy)
• Smoking—avoid smoking (adverse effects on coronary disease, adverse haemodynamic effects)
• Exercise—regular exercise should be encouraged
• Vaccination—patients should consider influenza and pneumococcal vaccinations