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International Journal of Contemporary Research in Multidisciplinary

International Journal of Contemporary Research In Multidisciplinary, 2024;3(1):09-19

Effect of Nursing Intervention Program on Maintaining Fluid and Electrolytes Balance among Patients with Congestive Heart Failure

Author Name: Dr. Nadia Mohamed Taha, Dr. Fathia Attia Mohamed, Dr. Maha Desoky Saleh Sakr, Samah Ebrahim Eldsouky Hasan Salama

Paper Type: research paper
Article Information
Paper Received on: 2023-11-19
Paper Accepted on: 2024-01-02
Paper Published on: 2024-01-05
Abstract:

Background: Fluid and electrolyte imbalance is a critical problem in Congestive Heart Failure (CHF) patients. They need to adhere to a therapeutic regimen for the maintenance of adequate fluid and electrolyte balance.

Aim of study: to evaluate the effect of a nursing intervention program on maintaining fluid and electrolyte balance among patients with congestive heart failure.

Subjects and Methods: This quasi-experimental study was conducted in the outpatient clinics of the cardiology department at Zagazig University Hospitals on 60 patients suffering from CHF. The tools used in data collection were an interview questionnaire form for knowledge and observation checklists for practice, in addition to an input/output sheet. The researcher prepared the educational health promotion program, implemented it, and measured its immediate and 3-month follow-up effects.

Results: Patients’ age ranged between 33 and 85 years, with 55.0% males. Patients’ knowledge improved from 3.3% pre-intervention to 81.7% post-intervention phase, and 75.0% at the follow-up (p<0.001). Their practices improved from 1.7% pre-intervention to 81.7% post-intervention, and 75.0% at follow-up (p<0.001). The prevalence of edema decreased from 73.3% pre-intervention to 26.7% at follow-up (p<0.001). In multivariate analysis, the study intervention was the main positive predictor of the knowledge and practice scores.

Conclusion and recommendations: The need-based educational intervention is effective in improving CHF patients’ knowledge, practices, and physical signs. The study recommends a wide-scale use of the program by nurses. The study should be replicated with a randomized clinical trial design for stronger evidence. Further research is proposed to assess the effectiveness of the program on the quality of life of the patients suffering from CHF.

Keywords:

Congestive Heart Failure, Educational Program, Fluid and Electrolyte Balance, Self- Care, Cardiovascular Dysfunction

Introduction:

Congestive heart failure (CHF) is a complex clinical syndrome in which the heart cannot pump enough blood to supply oxygen and nutrients to the body. In CHF is dyspnea, fatigue and fluid retention that can limit tolerance to exercise and functional capacity (Tinoco et al., 2021) [33]. It is an increasing global public health problem associated with higher expenditure rate and increased hospital admission as well as mortality (Qiu et al., 2021; Tsao et al., 2022)[27] [35]. Fluid and electrolytes balance is crucial for physiology of human body and its normal functioning and metabolism. The body’s homeostasis maintains fluid gain and loss balance. The body electrolytes (sodium, potassium, chloride, and bicarbonate) help regulate nerve, muscle function, and maintain acid-base balance and water balance. The vital organ for the fluid and electrolytes balance are the kidney and cardiovascular system (Trikhatri et al., 2019)[34]. Having the right concentrations of these electrolytes is important for maintaining fluid balance among the intracellular fluid (ICF) and extracellular fluid (ECF) compartments (Bennet et al., 2021)[5]. Self-care is critical in CHF management. It refers to specific behaviors that patients perform of their own accord to control their disease and maintain health. Health care reforms have increasingly shifted the self-management responsibility to patients and families, as hospital stays are becoming shorter and less frequent. Therefore, the critical role of patients in their own care is receiving increasing attention. (Gjoreski et al., 2020)[11]. In CHF, the capacity for self-care can be limited by low health literacy, cognitive deficit, depressive symptoms, presence of multiple comorbidities and low self-efficacy to perform self-care (Rêgo et al., 2018; Gordoreski et al., 2018)[28]. Therefore, they need serious help regarding teaching them how to deal with their illness independently in the absence of health professionals (National Institute of Health and Care Excellence, 2018)[24]. The nursing care plan for patients with CHF should include: relieving fluid overload symptoms, relieving symptoms of anxiety and fatigue, promoting physical activity, increasing medication compliance, decreasing adverse effects of treatment, teaching patients about dietary restrictions, teaching patient about self-monitoring of symptoms, and Teaching patients about daily weight monitoring is also an important role of the nurse (Lind et al., 2021; Shen et al., 2022)[22][30]. Many patients perceived that health care providers did not cover what they wanted to know, and they were given too little information on low-sodium foods or strategies to follow dietary recommendations (Zuraida et al., 2021)[36]. For this, nurses should interact with patients to identify their educational needs (Dalal et al., 2019)[8].

How to Cite this Article:

Dr. Nadia Mohamed Taha, Dr. Fathia Attia Mohamed, Dr. Maha Desoky Saleh Sakr, Samah Ebrahim Eldsouky Hasan Salama. Effect of Nursing Intervention Program on Maintaining Fluid and Electrolytes Balance among Patients with Congestive Heart Failure. International Journal of Contemporary Research in Multidisciplinary. 2024: 3(1):09-19


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