Running Head: NUTRITIONAL ASSESSMENT OF A HEART FAILURE PATIENT 1

Nutritional Assessment of a Heart Failure Patient

Jaime Umpleby

University of South Florida

NUTRITIONAL ASSESSMENT OF A HEART FAILURE PATIENT 2

Mrs. Leia Organa is a patient who has been recently diagnosed with Congestive Heart

Failure (CHF) and has been prescribed an oral diuretic. She is scheduled for discharge later this

morning, so a nutrition plan including patient education is necessary.

Disease Process

CHF results when there is inadequate filling or ejection by the left side of the heart to

supply enough blood to the systemic circulation (Valiyakizha Kkeveetil, Thomas, & Chander,

2016). It is vital that the patient receives enough macro and micronutrients, as a decline will

further progress the condition (Valiyakizha Kkeveetil et al., 2016).

In CHF, too much fluid in the bloodstream will cause the heart to strain to fight against

the resistance (DeNysschen, Platek, Helmer, Aronoff, & Zafron, 2017). The accumulation of

fluid causes edema in the pulmonary system due to the backflow of blood into the lungs since the

left side of the heart is unable to completely empty during a contraction (DeNysschen et al.,

2017). Mrs. Organa’s prescribed oral diuretic will cause her kidneys to filter sodium and water

out of her blood (Mayo Clinic, 2016). The fluid removed from the circulation will help lower the

workload of the heart by decreasing the volume of fluid in the vessels (Mayo Clinic, 2016).

Required or Restricted Nutritional Items

The advised fluid intake is about 1.5 liters (L) of water a day (DeNysschen et al., 2017).

Since sodium and water are removed from the vessels by the kidneys due to the diuretic, it is

vital that the patient meets the recommended amount of fluid each day (Mayo Clinic, 2016).

While hydration is important, too much fluid will cause the heart to work harder to push out a

higher blood volume with each contraction (Kaiser Permanente, 2014). Water binds to sodium,

so too much sodium in the diet will cause an increase in fluid in the vessels, resulting in an
NUTRITIONAL ASSESSMENT OF A HEART FAILURE PATIENT 3

increased volume (Kaiser Permanente, 2014). Salt and other forms of sodium need to be

restricted in the diet to the advised guideline of 500 mg per meal (Kaiser Permanente, 2014).

Another important restriction in Mrs. Organa’s nutrition plan is the limitation of saturated

fat and cholesterol (Kaiser Permanente, 2014). Too much saturated fat and cholesterol will clog

arteries through plaque build-up and lead to further complications (Kaiser Permanente, 2014).

Patient Education Regarding Proper Nutrition

To promote a fluid intake of 1.5 L of water per day, sources of water can come from

foods such as fruits and vegetables (DeNysschen et al., 2017). If different sources of fluid intake

are utilized throughout the day, a goal of 1.5 liters of water per day becomes more manageable.

To restrict salt intake to 500 mg per meal in Mrs. Organa’s diet, she should not add extra

salt while cooking or eating, and she should avoid processed foods like frozen meals that are

high in sodium (Kaiser Permanente, 2014). Instead, she should stick to fresh fruits, vegetables,

and meats. She will also need teaching on how to read nutrition labels, so while grocery

shopping she is able to tell which items will cause her to go over her sodium limit for the day.

To limit Mrs. Organa’s fat and cholesterol intake, she should trim fat off of meat when

cutting it, and resort to baking or grilling meat instead of frying (Kaiser Permanente, 2014).

When grocery shopping, she should look for fat-free or reduced fat options and continue to check

the nutrition labels for the percent daily value for fat and cholesterol.

Conclusion

Mrs. Organa’s newly diagnosed CHF demands a new nutrition plan for her to follow to

prevent any further heart complications. This nutrition plan involves a restriction on sodium

(salt), fat, and cholesterol, and the addition of fresh fruits, vegetables, meats, and sources of

water.
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References

DeNysschen, C., Platek, M.R., Helmer, D., Aronoff, N., & Zafron, M. L. (2017). Optimal

nutrition and hydration through surgical treatment trajectory. Seminars in Oncology

Nursing, (1), 61. Doi:10.1016/j.soncn.2016.11.006

Kaiser Permanente. (2014). Nutrition tips for congestive heart failure. Retrieved from

https://wa.kaiserpermanente.org/healthAndWellness/index.jhtml?item=/common/healthA

ndWellness/conditions/heartDisease/chfNutrition.html

Mayo Clinic. (2016). Diuretics. Retrieved from https://www.mayoclinic.org/diseases-

conditions/high-blood-pressure/in-depth/diuretics/art-20048129

Valiyakizha Kkeveetil, C., Thomas, G., & Chander, S.U. (2016). Original article: Role of

micronutrients in congestive heart failure: A systemic review of randomized controlled

trials. Tzu Chi Medical Journal, 28143-150. doi:10.1016/j.tcmj.2016.08.001