Knowledge Deficit R/T Congestive Heart Failure/Low Sodium diet AEB patient stating:

Patient will vocalize the importance of following his New 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.

CONGESTIVE HEART FAILURE (CHF): occurs when the heart does

First, Let me review CHF for you again

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.

Heres 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)

Some tips to lower sodium intake:

Remove the salt shakeryoull 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 foodscanned, 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

Food Group
Grain & Grain Products Vegetables

Recommended Servings 8 per day 4-5 per day 4-5 per day 2-3 per day 4-5 per week 2-3 per day 5 per week

Serving Sizes
1 slice bread 1 oz dry cereal c. cooked rice, pasta, cereal 1 c. raw leafy veggies c. cooked veggies 6 oz. vegetable juice 6 oz fruit juice 1 med. size fruit c. dried fruit c. fresh, frozen, or canned fruit

Examples of Good Choices

Whole wheat bread, English muffin, pita bread, cereals, grits, oatmeal Tomatoes, potatoes, carrots, peas, squash, broccoli, spinach, artichokes, sweet potatoes, beans

Fruits

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

Low-Fat or Non-Fat Dairy Foods Nuts, Seeds, & Legumes

8 oz. milk 1 c. yogurt 1.5 oz cheese

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

1.5 oz or c. nuts oz or 2 Tbsp. seeds c. cooked legumes 1 tsp. soft margarine 1 Tbsp low fat mayo 2 Tbsp light salad dressing 1 tsp vegetable oil

Unsalted: almonds, mixed nuts, peanuts, walnuts Unsalted sunflower seeds Kidney beans, lintels

Fats & Oils

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

Sweets

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

Does that mean.No more

Going out to eat

frozen pizza

BLTs & Soup

You dont need to give up everything you like

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

Creamy chicken soup..

ONE (1 cup) serving has 660 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 sodium add on the tortilla chips a 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 pizzas 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: Jennies First Clinical Group Laura Hardesty, Logan Simmons, Matt Hamilton, Kalisa McWhorter, Tammie Davis, Emily Secor, Jonathan Pitts, April Miller