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Heart Failure

Managing Heart Failure: Heart Failure Action Plan

​​​​​​​​​​Know When to Call Your Doctor or Seek Help

​​​​​​​​ ​​​​​GREEN ZONE: All Cle​ar​​​​​​​ ​​​
​​​​

Your heart failure is in good control if you have:

  • No shortness of breath
  • No swelling
  • ​No weight gain
  • No chest pain
  • No problem keeping up your activity level

Green Zone Means:

  • ​​​Your symptoms are under control
  • ​Keep taking your medications as ordered
  • Keep checking your weight every day
  • Continue to follow a 2 to ​3 gram sodium restricted diet
  • Keep all doctor appointments
  • ​It is safe to exercise

​​​​​​​​ ​​​​​YELLOW ZONE:​ Caution​​​​​​​ ​​​
​​​ ​
  • You gain 2 lbs or more overnight or more than 5 lbs in 1 week
  • You have an increased cough
  • You have increased swelling in your feet, ankles, legs or tummy
  • You feel more short of breath with activity
  • You find it hard to breathe when lying flat
  • You find it easier to sleep by adding pillows or sitting up in a chair
  • You feel more tired and don’t have the energy to keep up to your usual daily activities
​​​​

Yellow Zone Means:

  • You may need to adjust your medicines based on your symptoms
  • Take diuretic medicine as directed
  • If your symptoms or weight do not improve with extra diuretic medicine CALL one of the following:
​​Doctor



Community Care Nurse



​ ​​

​​​​​​ ​​​​​RED ZONE: Medical Alert​​​​​​​ ​​​​
​​​
  • You are struggling to breathe
  • Your shortness of breath does not go away while sitting still
  • You have chest pain that does not go away with rest or with medicine
  • You have trouble thinking clearly or are feeling confused
  • You have a fast heartbeat that does not slow down when you rest
  • You have fainted or lose consciousness
​​​

Red​ Zone Means:

  • ​You need to see a doctor right away
  • Go to the nearest emergency room department OR
  • Call 911
  • Call your doctor right away if you are entering the red zone

​​​​​​​Salt Restricted Diet

Salt is like a sponge, it keeps extra fluid in your body. Your heart has to work harder to pump this extra fluid. You are strongly encouraged to limit your salt intake to no more than 2300 mg each day (1 tsp. is about 2300 mg or 2.3 g of sodium). Watch for hig​h sodium foods. (See Benefits of Low Salt handout) ​

Recommendations:

  • Do not use salt when cooking.
  • Remove the salt shaker from the table.
  • To season food, use herbs and spices instead of salt.
  • Read food labels. Look for the words salt, sodium, Na, NaCl. If these words are listed in the first 5 ingredients, it means there’s a lot of salt in the product.
  • If the label reads less than 200 mg per serving, it’s an acceptable choice for you.
  • Stay away from foods that have a lot of salt (e.g., lunch meats, cheese, canned foods like soups and tomatoes, bacon, salted nuts, crackers, and party snacks, barbecue sauce, packaged salad dressings, ketchup, soya sauce, convenience foods like frozen dinners, pickles).
  • Ask your healthcare provider if you can use salt substitutes made with potassium. These are not good for everyone.

​​​​​Weight Monitoring

Sudden weight gain can be an early sign of fluid buildup. Watch for a weight increase of 2 lbs. (1 kg) or more overnight or 5 lbs. (3 kg) or more in 1 week. Call your family doctor or nurse if this happens or we may advise you how to take extra diuretics (water pills) as directed:

Be sure to weigh yourself every morning and remember to:

  • Empty your bladder first
  • Weigh yourself before breakfast
  • Wear the same amount of clothing every time you weigh yourself
  • Record your weight

​​​​​Activity

Walk 3 to 5 days a week or continue with your current activities if they are equal to the following:

Goal: 150 minutes per week (e.g. 30 minutes per day, 5 times per week)

​​​Week Amount of Exercise
​Week 1 and 2​​5 to 10 min; 5 times per week​
Week 3 and 410 to 15 min; ​5 times per week​
Week 5 and 6​15 to 20 min; ​5 times per week​
Week 7 and 820 to 30 min; ​5 times per week​​
  • Start slow, and slowly add more activity.
  • ​If unusually tired or ill, don't exercise.
  • Be active.
  • Plan ahead.
  • Walk in familiar areas with a friend.
  • Remember to use the 'talk test' to pace yourself.
  • Make sure to take time to rest during the day.
  • Set priorities.
  • Activity doesn't need to be hard or continuous. May do 15 min. in a.m. and 15 min. in p.m.
  • Stop if you become very short of breath, or have chest pain, or fatigue.
  • Exercise before meals or 90 minutes after meals.
  • You should return to your pre-walk or resting state within 10-15 minutes of exercising

​​​​​Monitoring - Monitor yourself for signs and symptoms of heart failure

  • ​​Increased shortness of breath with activity at rest or when lying down
  • Waking at night with shortness of breath
  • Bloating of your tummy
  • Cough
  • Heart racing/pounding
  • Cough
  • Swelling of your feet/ankles
  • Decreased appetite
  • Fatigue (feeling very tired)
  • Weakness
  • Weight gain

​​​​​Medications

You will be on several medicines to help with your treatment. For your medicines to work best, it’s important that you’re taking the right doses. To find the right doses, you can expect your medicine doses to be changed often.

Medicine changes will only happen if you’re stable enough to do so - this is a positive step.

Do not skip taking your medicine unless you are told to do so. You will be taking medicine that may make you feel light-headed for a little while, especially when you change position.

Call your doctor or nurse immediately if you experience:

  • Loss of balance because of light-headedness
  • Black dots or total blackness in your visual field
  • Any episode of unconsciousness or fainting
​​​

Some medicines cause your body to hold fluid. These medicines are not recommended for people with heart failure. Please be cautious with:

  • Non-steroidal anti-inflammatory medications (Ibuprofen, Motrin®, Advil®, Celebrex®, Indocid®)
  • Antacids and laxatives (Maalox®, Ex-lax®)
  • Select diabetic medications (Avandia®, Actos®)

Check with your pharmacist before you buy any non-prescription medications.

Some herbal remedies can cause problems with your treatment. Please let your doctor or nurse know if you’re taking any herbal therapies.

​​​​​Mental Well-being

Living with chronic illness can be difficult. Chronic illness may cause changes in mood, work, relationships and/or finances. You may require additional support that we are able to assist you with.

​​​​​Seuxal Well-being

Sometimes chronic illness and fatigue can change how you mentally and physically approach intimacy. These changes may cause you and your partner to feel stressed or uneasy. There are physical reasons why your body changes in response to intimacy. There are options you can try that do help. Please feel free to talk about your sexual well-being with your healthcare provider.

For 24/7 nurse advice and general health information call Health Link at 811.​

​​​​

Current as of: May 11, 2018

Author: Cardiovascular and Stroke Strategic Clinical Network, Alberta Health Services