Heart Failure
Publication Date: May 11, 2018
Screening and Referral
Screening and Referral
The registered dietitian nutritionist (RDN) plays an integral role in the interdisciplinary healthcare team by designing the optimal nutrition prescription that complements drug therapy, physical activity, and behavioral therapy.
Based on the client’s treatment plan and comorbid conditions, other nutrition practice guidelines may be needed in order to provide optimal treatment.
HF: Medical Nutrition Therapy (MNT)
For adults with heart failure (HF) (NYHA Classes I–IV/AHA Stages B, C and D), the RDN should provide MNT to treat HF and contributing comorbidities, such as hypertension, disorders of lipid metabolism, diabetes mellitus and obesity. Every patient with HF should have a clear, detailed, and evidence-based plan of care that ensures the achievement of guideline determined medical therapy (GDMT) goals, effective management of comorbid conditions, timely follow-up with the healthcare team, appropriate dietary and physical activities, and compliance with secondary prevention guidelines for cardiovascular disease. Research reports that MNT resulted in a significant decrease in sodium intake and maintenance of body weight. (Strong, Imperative)
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HF: Frequency and Duration of MNT
For adults with HF (NYHA Classes I–IV/AHA Stages B and C), the RDN should provide an initial MNT encounter lasting 30–60 minutes, with a follow-up encounter four to six weeks later, and determine if and when additional MNT encounters are needed. Research reports that this frequency and duration of MNT resulted in a significant decrease in sodium intake, as well as maintenance of serum sodium levels and body weight. (Fair, Conditional)
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HF: Frequency and Duration of MNT in Advanced HF
For adults with advanced HF (NYHA Class IV/AHA Stage D), the RDN should provide an initial MNT encounter and additional follow-up encounters as often as every two weeks. Research reports that this frequency and duration of MNT resulted in increased exercise tolerance, higher physical component scores on quality of life measures and decreased anxiety, as well as maintenance of body weight. (Fair, Conditional)
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Nutrition Assessment
...n Assessment The RDN should assess the followin...
...trition Assessment and Monitoring and Evaluatio...
...th HF should have a clear, detailed, and evide...
...easure Resting Metabolic Rate (RMR) in Adults...
...indirect calorimetry is available,...
...R in AdultsIf indirect calorimetry is not a...
...Estimate RMR in Adults with Advanc...
...F: Estimate Total Energy Needs Using RMR an...
Nutrition Intervention
...Individualize Energy IntakeFor adults with...
HF: Intentional Weight Loss in Obesity...
...: Individualize Protein IntakeFor adu...
...dualize Sodium and Fluid IntakeFor adu...
...courage Individualized Physical Activity Plan...
...Self-Care for AdultsFor adults with HF (NYHA Class...
...n of Care for AdultsFor adults wit...
...t with Interdisciplinary Health Care Team Rega...
Nutrition Monitoring and Evaluation
...Monitoring and Evaluation...
...Monitor and Evaluate Effectiveness of MNT...
