LOW SODIUM DIET&

CONGESTIVE HEART FAILURE

TEACHING THE PATIENT

I am glad you came

in for your check-up. I

know we covered a lot of

information last time regarding

your CHF. Do you have any

q

uestions?

I have some questions about the new diet I am supposed to follow…

NURSING DIAGNOSIS..Knowledge Deficit R/T Congestive Heart

Failure/Low Sodium diet AEB patient stating:

“Why do I

have to be on this

diet?”

“I can't figure out what I am supposed to eat and what to avoid eating”

Patient will vocalize the importance of following hisNew DASH (low sodium) diet AEB:

giving 2 examples of foods naturally low in sodium

give 2 examples of foods he typically eats that are on the new diet plan

giving 3 examples of seasoning alternative to salt.

First, Let me review CHF for you again…

occurs when the heart does not pump as well as it should, and the blood backs up in your veins. This backup can lead to shortness of breath, ankle, foot or leg swelling, congestion, and fatigue.

CONGESTIVE HEART FAILURE (CHF):

Here’s a handout that shows you some of the

symptoms that occur with CHF. Your history of HTN & excess fluid with CHF

are why the doctor has put you on a Low Sodium Diet.

The DASH diet

(low sodium diet)..

D – dietary A – approach to S – stop H – hypertension (and YOUR swelling)

– Remove the salt shaker—you’ll be less likely to use it.

– Use spices, herbs, and other seasonings instead of salt to flavor foods. Experiment with new flavors. Try citrus fruits, black pepper, herbs. Use Onion Powder instead of onion Salt.

– Eat fresh foods—canned, processed, & smoked meats, fish, & vegetables & side dishes are usually higher in sodium.

– Snack on fresh fruits and vegetables -instead of salty snack foods such as pretzels, chips, or popcorn. Fruits and vegetables are good sources of fiber & potassium, & they are low in calories.

– Read labels before purchasing food. The amount of sodium a product contains is listed on the label

Some tips to lower sodium intake:

Food Group Recommended Servings

Serving Sizes Examples of

Good Choices

Grain & Grain Products

8per day

• 1 slice bread• 1 oz dry cereal• ½ c. cooked rice, pasta, cereal

Whole wheat bread,English muffin, pita bread,cereals, grits, oatmeal

Vegetables 4-5per day

• 1 c. raw leafy veggies• ½ c. cooked veggies• 6 oz. vegetable juice

Tomatoes, potatoes, carrots, peas, squash, broccoli, spinach, artichokes, sweet potatoes, beans

Fruits 4-5per day

• 6 oz fruit juice• 1 med. size fruit• ½ c. dried fruit• ½ c. fresh, frozen, or canned fruit

Apricots, bananas, dates, citrus fruits, melons, peaches, pineapples, raisins, strawberries

Low-Fat orNon-FatDairy Foods

2-3per day

• 8 oz. milk• 1 c. yogurt• 1.5 oz cheese

Skim, low-fat, 1% - milk, buttermilk, yogurtPart-skim or non-fat cheeses

Nuts, Seeds, & Legumes

4-5per week

• 1.5 oz or ⅓ c. nuts• ½ oz or 2 Tbsp. seeds• ½ c. cooked legumes

Unsalted: almonds, mixed nuts, peanuts, walnutsUnsalted sunflower seedsKidney beans, lintels

Fats & Oils 2-3per day

• 1 tsp. soft margarine• 1 Tbsp low fat mayo• 2 Tbsp light salad dressing• 1 tsp vegetable oil

Soft margarine, low-fat mayo, light salad dressings, vegetable oil (olive, corn, canola)

Sweets 5per week

• 1 Tbsp sugar• 1 Tbsp jelly/jam• 8 oz lemonade

Maple syrup, sugar, jelly, jam, fruit-flavored gelatin, jelly beans, hard candy, fruit punch, sorbet

It is recommended to reduce sodium intake as

much as possible. 1500mg/day

has shown in studies to lower BP &

keep CHF symptoms from being a

consistent problem

BLT’s & Soup

Going out to

eat

frozen pizza

Does that mean….No more…

You don’t need to give up everything you like

Use caution…

At the grocery..

• Read nutrition labels and choose foods that are low sodium * if you have to buy canned vegetables be sure to rinse them in water to help reduce the amount of sodium

• Buy fresh or frozen vegetables & foods * Make your own soups there are lots of websites that have recipes for low sodium cooking

• Stay away from the hot dogs, pre-packaged lunch meats, & bacon * These are loaded with sodium as a preservative

• When dining out, look for low sodium items on the menu * Some restaurants are starting to offer L/S items, if not listed on the menu ASK many chefs are willing to alter or prepare dishes to help you..

Sodium is naturally present in many foods & added to most prepared & processed foods.

Creamy chicken soup..

ONE (1 cup) serving has660 mg of sodium-eat the entire can = 1320 mg!!

Black bean salsa..

Sounds healthy…but look closer…

ONE (1/2 cup) serving:506 mg of sodiumadd on the tortilla chipsa 1 oz. serving (approx. 11 chips) adds another 120-240 mg…

I think I get it now… • I need to eat fresh fruits & vegetables

• I have always enjoyed cooking so I can start learning how to make my own soups and make veggie pizza’s instead of buying frozen

• Instead of using salt to season my foods I should try things like citrus, herbs, and spice blends like Ms. Dash

Goal met. Patient vocalized understanding of New DASH (low sodium) diet. AEB:giving 2 examples of foods naturally low in sodium, gave 2 examples of foods he typically eats that are on the new diet plan, and 3 examples of seasoning alternative to salt.

References..• Wilkinson (V1) pages: 186, 981• Med Surg Nursing 6th Edition (V1) page: 778• American Heart Association: www.americanheart.org/

Presented by: Jennie’s First Clinical Group Laura Hardesty, Logan Simmons, Matt Hamilton, Kalisa McWhorter, Tammie Davis, Emily Secor, Jonathan Pitts, April Miller