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Nutritional Assessment: Congestive Heart Failure (CHF)

Kimone K. Wright
University of South Florida College of Nursing
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Congestive heart failure is a term used to describe blood congesting the liver, abdomen,

lungs, and lower extremities (Mayo Clinic, 2015). In congestive heart failure, the heart does not

pump blood efficiently, hence, it does not deliver enough oxygen to the body. According to Rich

(2015), congestive heart failure is a major public health problem in the United States today as a

result of its high and increasing prevalence in the older population as well as its substantial

impact on healthcare costs and quality of life. Fortunately, this condition can be treated with a

number of medications and lifestyle changes.

According to Paterna, Gaspare, Fasullo, Sarullo, and Di Pasquale (2008), patients with

advanced CHF should manage their condition by restricting sodium, engaging in moderate

physical activity, and using personalized treatment that include: digitalis, diuretics, and

Angiotensin Converting Enzyme Inhibitors (ACE-Inhibitors). Mrs. Leia Organa, who is newly

diagnosed with Congestive Heart Failure (CHF), was prescribed an oral diuretic to manage her

condition. However, she will also need to adjust her lifestyle for the process to be effective.

Maintaining an appropriate diet, by monitoring the amount of electrolytes, carbohydrates,

proteins, and fats consumed, may improve the quality of life for Mrs. Organa. Also, exercising,

weight monitoring, and taking medications as prescribed, can help her feel better and improve

her heart function.

If Mrs. Organa consumes too much salt or drink too much fluid, her body's water content

may increase. This is because too much sodium contributes to water retention, which causes

shortness of breath, swollen legs, ankles and feet (Mayo Clinic, 2015). This increase in water

volume will cause her heart to work harder. The patient may reduce the salt content in her diet by

choosing plenty of fresh fruits and vegetables which contain only small amounts of salt. Other

foods that are low in salt, and contains carbohydrates and proteins, include: fresh meats, poultry,
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fish, dry and fresh legumes, eggs, milk, yogurt, plain rice, pasta and oatmeal. Mrs. Organa should

avoid herb or spice mixtures that contain salt or sodium, and use substitutes such as lemon juice

or fresh ground pepper to accent natural flavors if needed. Another great way for the patient to

reduce salt in her diet is to check the nutrition facts on the label for sodium content per serving. It

is also important that she chooses packaged foods with a sodium content less than 350

milligrams for each serving. If salt or sodium is listed in the first five ingredients, it is too high in

sodium (University of California San Francisco Medical Center, 2015).

On the other hand, the diuretic prescribed for Mrs. Organa may promote sodium and

water loss by blocking sodium and chloride reabsorption. This may cause a decrease in fluid

volume, hence, a decreased risk of edema (Kee, 2015, p. 621). Also, many diuretics cause the

loss of electrolytes, including potassium, magnesium, chloride, and bicarbonate (Kee, 2015, p.

621). Therefore, it is recommended that Mrs. Organa uses supplements to replace the electrolytes

lost when taking the prescribed diuretic.

Along with avoiding high-sodium foods, Mrs. Organa should limit the amount of

saturated fat, trans fat and cholesterol in her diet. A diet high in fat and cholesterol is a risk factor

for coronary artery disease, which often underlies or contributes to heart failure (Mayo Clinic,

2015). A diet high in fat may also contribute to weight gain and more stress on the heart.

In addition to the above, Mrs. Organa should aim to eat a diet that includes whole grains,

fat-free or low-fat dairy products, and lean proteins. She should also maintain a healthy weight,

reduce stress, and be active. These will reduce the demand on her heart muscles. Furthermore,

she should stay away from alcohol, as this may interact with her medication, weaken her heart

muscle, and increase her risk of abnormal heart rhythms (Mayo Clinic, 2015). Also, she should

seek help from a dietician in planning a balanced diet that will help her manage her condition.
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References

Kee, J. L., Hayes, E. R., & McCuistion L. E. (2015). PHARMACOLOGY: A PATIENT-

CENTERED NURSING PROCESS APPROACH. Missouri: Elsevier.

Mayo Clinic. (2015, August 18). Diseases and Conditions Heart failure: Causes. Retrieved from

http://www.mayoclinic.org/diseases-conditions/heart-failure/basics/causes/con-

20029801?Page=1&cItems=10

Mayo Clinic. (2015, August 18). Diseases and Conditions Heart failure: Lifestyle and home

remedies. Retrieved from http://www.mayoclinic.org/diseases-conditions/heart-

failure/basics/lifestyle-home-remedies/con-20029801?Page=1&cItems=10

Paterna, S., Gaspare, P., Fasullo, S., Sarullo, F. M., & Di Pasquale, P. (2008). Normal-sodium

diet compared with low-sodium diet in compensated congestive heart failure: is sodium

an old enemy or a new friend?. Biochemical Society, 114, 222. doi:10.1042/CS20070193

Rich, Michael W. (2015, April 27). CONGESTIVE HEART FAILURE IN OLDER ADULTS:

Epidemiology, Pathophysiology, and Etiology of Congestive Heart Failure in Older

Adults. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1532-

5415.1997.tb02968.x/abstract?

userIsAuthenticated=false&deniedAccessCustomisedMessage#fn1

University of California San Francisco Medical Center. (2015). Diet and Congestive Heart

Failure. Retrieved from

http://www.ucsfhealth.org/education/diet_and_congestive_heart_failure/