CHF your sodium

intake. In addition, many salt substitutes contain potassium

Lifestyle and home remedies
chloride. Too
Making lifestyle changes can often help relieve signs and
much potassium can be harmful if you have kidney problems
symptoms of heart failure
or if you're
and prevent the disease from worsening. These changes may
taking certain medications for treatment of heart failure. A
be among the most
dietitian can help
important and beneficial you can make:
you outline a healthy, low-salt diet, but it's up to you to stick to

it without
Stop smoking. Smoking damages your blood vessels, exception.
reduces the amount of 
oxygen in your blood and makes your heart beat faster. If you
Maintain a healthy weight. If you're overweight, your
smoke, ask yourdoctor to recommend a program to help you
dietitian will help you
quit. You can't be considered fora heart transplant if you
continue to smoke. work toward your ideal weight.

 

Weigh yourself daily. Do this each morning after you've Limit fats and cholesterol. In addition to avoiding high-

urinated, but before sodium foods, limit

you've had breakfast. Notify your doctor if you have a weight your intake of saturated fat, trans fat and cholesterol. A diet

gain of 3 or high in fat and

more pounds in a day. It may mean that you're retaining cholesterol is a risk factor for coronary artery disease, which

fluids and need a often underlies or

change in your treatment plan. Record your weight every contributes to heart failure.

morning and bring 

the record with you to your doctor's visits. Limit alcohol and fluids. Excessive use of alcohol can
 directly weaken your
Restrict sodium. Sodium is a component of salt. Too much heart muscle or increase your risk of abnormal heart rhythms

sodium that may worsen

contributes to water retention, which makes your heart work existing heart failure. Alcohol may also interact with some

harder and causes medications used

shortness of breath and swollen legs, ankles and feet. For to treat heart conditions. Your doctor likely will advise you

people with heart to abstain from

failure, the recommended sodium intake is no more than 2,000 alcohol if you have heart failure. If you have severe heart

milligrams a failure, your doctor

day. Keep in mind that most of this salt is already added to may also suggest you limit your total intake of fluids.

prepared foods,
and be careful when using salt substitutes. Some substitutes or
"lite" salts
contain a mixture of salt and other compounds. To get that
familiar salty taste,
you may use too much of the substitute and actually not reduce

Exercise. Exercise was once forbidden for people with heart
failure. But,
moderate exercise helps keep the rest of your body healthy
and conditioned,
reducing the demands on your heart muscle. Before you start
exercising losartan (Cozaar) and valsartan (Diovan), have many of the
though, talk to your doctor about an exercise program that's
beneficial effects
right for you.
of ACE inhibitors, but they don't cause a persistent cough.
Your doctor may suggest a walking program. Check with
your local hospital They may be an

to see if it offers a cardiac rehabilitation program; if it does, alternative for people who can't tolerate ACE inhibitors.
talk to your doctor 
about enrolling in the program.
Digoxin (Lanoxin). This drug, also referred to as digitalis,

increases the
Reduce stress. When you're anxious or upset, your heart strength of your heart muscle contractions. It also tends to
beats faster and you slow the heartbeat.Digoxin reduces heart failure symptoms

breathe more heavily. This can make heart failure worse, and improves your ability to live withthe condition.

since your heart is 

already having trouble meeting the body's demands. Find Beta blockers. This class of drug slows your heart rate and

ways to reduce reduces blood

pressure. Examples include carvedilol (Coreg), metoprolol
Angiotensin-converting enzyme (ACE) inhibitors. These (Lopressor) and

drugs help people bisoprolol (Zebeta). These medicines also reduce the risk of

with heart failure live longer and feel better. ACE inhibitors some abnormal

are a type of heart rhythms. Beta blockers may reduce signs and

vasodilator, a drug that widens or dilates blood vessels to symptoms of heart failure

lower blood and improve heart function.

pressure, improve blood flow and decrease the workload on 
the heart.
Diuretics. Often called water pills, diuretics make you
Examples include enalapril (Vasotec), lisinopril (Prinivil,
urinate more frequently
Zestril) and
and keep fluid from collecting in your body. Commonly
captopril (Capoten). ACE inhibitors also blunt some of the
prescribed diuretics
effects of
for heart failure include bumetanide (Bumex) and furosemide
hormones that promote salt and water retention. ACE
(Lasix). The
inhibitors can cause an
drugs also decrease fluid in your lungs, so you can breathe
irritating cough in some people. It may be best to put up with
more easily.
the cough, if you
Because diuretics make your body lose potassium and
can, to gain the medication's benefits. But be sure to discuss
magnesium, your
this with your
doctor may also prescribe supplements of these minerals. If
doctor. Switching to another ACE inhibitor or an angiotensin
you're taking a
II receptor
diuretic, your doctor will likely monitor levels of potassium
blocker (ARB) may relieve the problem.
and magnesium in

your blood through regular blood tests.
Angiotensin II (A-II) receptor blockers (ARBs). These

drugs, which include
Aldosterone antagonists. These drugs include Fatigue and weakness

spironolactone (Aldactone) 
and eplerenone (Inspra). They're primarily potassium-sparing Rapid or irregular heartbeat
diuretics, but

they have additional properties that help the heart work
Shortness of breath (dyspnea) when you exert yourself or
better, may reverse
scarring of the heart and may help people with severe heart when you lie down

failure live longer. 

Unlike some other diuretics, spironolactone can raise the Reduced ability to exercise
level of potassium in

your blood to dangerous levels.
Persistent cough or wheezing with white or pink blood-tinged
Keep track of the medications you take. Make a list and
phlegm
share it with any

new doctors treating you. Carry the list with you all the time.
Swelling in your abdomen, legs, ankles and feet


Keep track of your weight and bring the record to visits
Difficulty concentrating or decreased alertnes
with your doctor.
An increase in weight can be a sign you're accumulating
fluid. Your doctor
Heart failure, also known as congestive heart failure (CHF),
may instruct you to take extra diuretics if your weight has
means your heart can't
increased more than
pump enough blood to meet your body's needs. Over time,
a pound or so in a day.
conditions such as

coronary artery disease or high blood pressure gradually
Keep track of your blood pressure. Consider purchasing a leave your heart too weak or
high-quality stiff to fill and pump efficiently.

home blood pressure monitor. Keep track of your blood You can't reverse many conditions that lead to heart failure,
but heart failure can often
pressure between
be treated with good results. Medications can improve the
doctor appointments and bring the record with you to visits.
signs and symptoms of
 heart failure and lead to improved survival. Lifestyle
Write down your questions. Before a doctor appointment, changes, such as exercising,

prepare a list of reducing salt intake, managing stress, treating depression,

any questions or concerns. For example, is it safe for you and and especially losing excess

your partner to weight, also can help prevent fluid buildup and improve your

have sex? Most people with heart failure can continue sexual quality of life.

activity once The best way to prevent heart failure is to control risk factors

symptoms are under control. and aggressivelymanage any underlying conditions such as
coronary artery disease, high bloodpressure, high cholesterol,

diabetes or obesity.
Ask for clarification. Make sure you understand what your

doctor is saying.
PC clutching chest, rapid breathing),

Acute pain and hemodynamic response

(BP/heart rate changes).
related to tissue
Variation of appearance and
ischemia as
behavior of patients in pain may
evidenced by
present a challenge in assessment.
facial grimacing
Most patients with an acute MI
restlessness,
appear ill, distracted, and focused
changes in level
on pain. Verbal history and deeper
of
investigation of precipitating
consciousness,
factors should be postponed until
Blood pressure
pain is relieved. Respirations may
of 150/100 mm
be increased as a result of pain
Hg; Pulse rate of
and associated anxiety; release of
106 beats per
stress-induced catecholamines
minute, and
reports of chest increases heart rate and BP.

pain without Obtain full description of pain

radiation. from patient including location,
Within 24 hours intensity (0²10), duration,
Mr. M.I. will characteristics (dull/crushing), and

verbalize radiation. Assist patient to

quantify pain by comparing it to
relief/control of
other experiences.
chest pain
within Pain is a subjective experience and

appropriate must be described by patient.

time frame for Provides baseline for comparison to

administered aid in determining effectiveness of

medications; therapy, resolution/progression of

and, display problem.

reduced tension, Review history of previous
relaxed manner, angina, anginal equivalent, or MI
ease of pain. Discuss family history if

movement pertinent.

Independent May differentiate current pain from

 Monitor/document preexisting patterns, as well as

characteristics of pain, noting identify complications such as

verbal reports, nonverbal cues extension of infarction, pulmonary

(e.g., moaning, crying, embolus, or pericarditis

restlessness, diaphoresis,