Routinely instigate
non-pharmacological
treatment in people with CHF
Strong evidence supports the routine instigation
of non-pharmacological measures as a central
component of CHF management.
Educate people with CHF about
self-management
Teach people with CHF to monitor and control their
fluid balance.
• Limit dietary sodium to less than 2 g/day,
and fluid intake to < 2 L/day (1.5 L for severe
CHF), although this will depend on individual
circumstances. Limit caffeine to 1–2 drinks per
day.
• Use the person’s weight after correction of
fluid overload as a benchmark. Explain that
steady weight gain over days may indicate fluid
retention. Instruct people to weigh themselves
each morning (after urinating and before
dressing and breakfast), and to contact a doctor
or specialist heart failure nurse immediately if
there is a 2 kg gain or loss over 48 hours.
• Explain symptoms of dyspnoea, oedema and
bloating, and advise people to report these
symptoms if detected.
• Some people can learn to self-adjust diuretics
(e.g. double the dose if there is evidence of
retention).
Advise people with CHF about healthy lifestyle and
prevention strategies.
• Minimise alcohol intake: should not exceed one
to two standard drinks per day. Patients who
have alcohol-related cardiomyopathy should not
consume alcohol to help slow their disease’s
progression.
• Quit smoking.
• Vaccinate against influenza and pneumococcal
disease.
• Bed rest when clinically unstable or during an
acute exacerbation.