Microsoft word - chf patient pat evised 5-05.doc

Congestive Heart Failure
Patient Pathway
Welcome to Griffin Hospital. This leaflet has been designed as an aid to inform and prepare you for what you can anticipate during your stay with us. Please keep in mind this is only an outline of the way your health problem might be managed. The information in this brochure may vary to meet you individual needs as determined by your physician. Any questions you may have regarding these guidelines or any aspect of your care should be directed to your physician or primary nurse. The estimated number of days you will be in the hospital is 4. This could vary depending upon your progress. Patient Name Primary Nurse Extension# ( Griffin Logo) (Planetree Logo) Day One
(Admission – First 24 Hours)
Consults – Your physician may request that a
specialist in cardiology examine you (consult).
This may occur at any time during your
hospitalization.
Tests – Blood for testing may be drawn, an ECG
(electrocardiogram) and an echocardiogram may
be done, which will give the doctor important
information related to the function of your heart.
Vital Signs – Your temperature, pulse and blood
pressure will be checked as ordered by your
physician. You may be weighed daily.
Treatments – You may receive oxygen. An
intravenous (IV) will be started, to administer
medications and fluids as needed.

Medications – Medications will be ordered by
your doctor. Inform him/her of medications you
are taking at home. You may receive a diuretic
medication (Lasix) that will probably increase the
frequency with which you urinate. Measurement
of liquid intake and output will be monitored, so
you may be required to use a bedpan or urinal.
Activity – Your activity level will be ordered by
your physician depending on your condition.
Report to the nurse any feelings of shortness of
breath, chest discomfort or extreme tiredness.
Diet – You may be given a low salt diet and may
have a limit set on the amount of fluids you drink.
Discharge Plan – Your nurse may ask you
questions about your home situation and contact
our Continuing Care Department based on your
needs for discharge. A Griffin Continuing Care
Coordinator may contact you about plans for
discharge.
Teaching – Your nurse will review with you a
brochure called “Speak Up”. The “Speak Up”
program is intended to help you to become more
involved in your care. You will be instructed
about the importance of your activity levels, diet
restrictions, sodium restriction, fluid balance and
daily weights. Your physician or nurse will review
your plan of care with you and answer any
questions you may have.
Day Two

Tests – Blood for testing may be drawn. An
ECG and/or x-ray may be done if ordered by
your physician.
Vital Signs – Temperature, pulse, blood
pressure and respirations will be checked as
ordered by your physician.
Treatments – Oxygen and your IV may be
continued depending on your physician’s
orders.
Weight – You may be weighed daily. Your
nurse will explain why this is important.
Medications – You will probably continue to
receive a diuretic (Lasix). The doctor may
adjust the doses of your medications. Please
ask your doctor or nurse to explain the
medications you are receiving if you do not
understand what they are for.
Activity – Your activity will be increased as
tolerated.
Diet – You will continue on a low salt diet
with possible fluid restriction.
Discharge Plan – Your Continuing Care
Coordinator may meet with you today to
begin to discuss discharge plans with you and
your family.
Teaching – Your nurse will review with you
your plan of care for today. Ask questions if
you don’t understand your plan of care.
Day Three

Tests – There may be no tests scheduled for
today. Your doctor may discuss a weight goal
with you today and ways for you to achieve
and/or maintain it.
Vital Signs – Your temperature, pulse blood
pressure, and respirations will be checked as
ordered by your physician.
Treatments – Your oxygen and IV may be
discontinued today.

Medications
– Continue to ask questions
about the medications you are receiving if you
do not understand what they are for.
Activity – Your activity will continue to be
increased as tolerated. Please report any
shortness of breath or extreme tiredness to
your nurse. Let your nurse know if you have
not had a bowel movement since admission.
Diet – You will continue on a low salt diet
with possible fluid restriction.
Discharge Plan – Definitive arrangements
for discharge will be made, including follow
up appointment, and arrangements for any
necessary outpatient testing. Your case
manager from the Continuing Care
Department and/or nurse may discuss any
unresolved issues with you. You may be
discharged any time between day 3 and day 5
depending on your status and doctor’s
decision. Discharge time is before 11:00 am.
Teaching – Before you go home, your nurse
will review your discharge instructions,
explain your plan of care and answer any
questions you may have about the items listed
above.
Day Four

Essentially, the same as day 3. You will
receive more information and education about
your diagnosis. Before you go home, your
nurse will review your discharge instructions,
explain your plan of care and answer any
questions you may have.
Your diagnosis is Congestive Heart Failure (CHF). There are several things you can do to help you feel better and to improve your health. They include the following: 1. Take all medications listed on the
Discharge Instruction Sheet as directed. Always carry your medication list. Make sure you always have an ample supply of your medications at home. 2. Limiting salt in your diet and cutting
back on cholesterol and saturated fat are important parts of your treatment and management of your CHF. You may also need to limit your fluid intake and eat foods rich in potassium. 3. Each morning, you should weigh
yourself (after you urinate and before you eat breakfast) and record your weight. Remember to take your weight chart with you to every doctor’s appointment. 4. Quitting smoking is a vital part of your
treatment and management of your Congestive Heart Failure and can help prevent the development of other diseases that may shorten your life. You can contact the Connecticut QuitLine at 1-866-363-4224 for information on smoking cessation classes available in our community. 5. Daily exercise can be an important part
of your treatment plan. You should check with your physician before starting any plan. Exercise should be done in moderation. 6. When Should You Call Your Doctor?
• You have severe difficulty breathing. • You notice you are getting tired 1 day, 3 lbs or more in 2 days or 4 lbs in 1 week. • Your pulse is less than 60 for 2 days • Your feet swell more than usual. • You have side effects from your Call 911 if you have the following:
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Severe dizziness, fainting or shortness of breath

Source: http://www.planetree.nl/wp-content/uploads/Internationaal-Patient-Pathway-hartfalen-Griffin.pdf

Doi:10.1530/edm-13-0080

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