Question

Heart failure; 78 years old, newly diagnosed

1. What's the general education about the diagnosis?

2. Discharge intrustuons/planning

3. Activity/diet

4. Prevention

5. Call MD or return to the hospital if?

6. Medications (at least 3, include action, potential side effects, dosage instructions, and when the patient should follow-up with their provider)

Answer 1

1. General education:

It's a conditions of the heart where there will be collection of fluid in the lungs, it leads to breathing difficulties and it is a progressive disease.

2. General instructions:

a) take adequate rest

b) avoid exertion

c) watch for sudden weight gain ( it indicates the condition of the heart is getting worse)

d) engage in mild activities like gardening which makes the life enriched

e) take medicines according to prescription

3 Activity

A) can go for evening walk in level road for 10 minutes

B) hobbies like gardening and craft work can be done

Diet

A) avoid canned food

B) avoid salted food, reduce salt in the diet

C) eat more vegetables

D) drink water as needed not more than that

4) prevention

a) do regular medical check up like echo

B) avoid smoking

5) Call MD in following situations

1) if breathing difficulty out of proportion to activity

2) sudden weight gain

3) palpitation

4) chest pain

5) tiredness

6) Medication

1) Digoxin : which can lead to a small increase in cardiac output dose:3.4 to 5.1mcg/kg/day

Side effects: dizziness diarrhoea

2) Furosemide: 20 to 40mg twice daily, action diuretic, side effect: increased sodium loss, muscle cramps

3)Metoprolol: beta adrenergic blocker, reduces the heart rate and thus helps in reducing exertion of heart.

Dose: 100mg/day

Side effects: bradycardia