Question

The nurse is caring for a patient who was admitted for exacerbation of congestive heart failure (CHF). The nurse notes severe bilateral edema in the patient's lower extremities 1. What interventions should the nurse perform to reduce edema in the patient's lower extremities? 2. What dietary changes should the nurse recommend to the patient to reduce edema? 3. What can you teach and include in discharge planning so that the patient can monitor his CHF at home?

Answer 1

1. Interventions to reduce edema in lower extremities :

• Keep the lower extremities in slightly elevated position (around 15-30 degrees). Make use of pillows or suspension slings.
• Perform exercises like ankle toe movements and foor circumduction
• Use of electrotherapy : faradism under pressure can help relieve swelling
• Use of compression bandages or pressure stockings

Dietary recommendations to reduce edema in CHF patients :

• Reduce the sodium intake : consume less salt
• Check the labels for sodium contentvbefore buying packed food
• eat more fresh vegetables and fruits
• eat diet rich in fibre content
• eat fresh foods like fresh meat, poultry, fish, legumes.
• Consume more dairy products
• Avoid smoking and alcohol
• Eat more home cooked food. Avoid outside food, fatty and oily food.

3. Home monitoring for CHF patients include :

• Checking weight regularly : CHF causes fluid retention which may increase weight of the patient
• Check parameters like blood pressure, heart rate and lulse regularly
• Check for edema of ankles, foot and abdomen
• Check for fatigue and shortness of breath.
• Take medications on set time and do not skip