Congestive Heart Failure Patient Pathway

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1 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# Congestive Heart Failure Patient Pathway ( Griffin Logo) (Planetree Logo) 130 Division St., Derby, CT (203)

2 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.

3 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.

4 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.

5 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.

6 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 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 faster. You gain more than 2 lbs or more in 1 day, 3 lbs or more in 2 days or 4 lbs in 1 week. Your pulse is less than 60 for 2 days in a row. Your feet swell more than usual. You have side effects from your medications. You cough or have trouble breathing when you lay down at night. Call 911 if you have the following: - Severe dizziness, fainting or shortness of breath - Tightness or pressure in your chest.