Weigh yourself every day
Monitoring your weight is important because your weight is one way to tell if your heart function is worsening and/or your medications are working to reduce excess body fluid. Fluid retention can be a sign of worsening heart failure or a sign that your medications need to be adjusted. When you weigh yourself:

1. Use the same scale.
2. Wear similar clothing each time you weigh yourself.
3. Weigh yourself at the same time each day (for example, when you get up in the morning.
4. Weigh yourself before eating and after urinating.
5. Record your weight in a diary or on a calendar.
6. Call your doctor or nurse if you gain 3 pounds in one day or 5 pounds in one week.
7. Follow the guidelines below if you notice any signs of increased swelling or fluid retention. You may be retaining fluid if your belt feels tighter, your belly seems more swollen, your clothes don’t fit as well, your feet and ankles become swollen, your shoes become tight; or your shoe laces seem shorter.

• Eliminate 500 mg of sodium*  from your diet for two days (today and tomorrow) and
• Decrease the liquids you drink by 360 cc (1 and ½ cups) for two days (today and tomorrow).
• If you do not notice a decrease in body fluid or a decrease in weight after restricting sodium and fluid for two days, call your doctor or nurse. Your medications may need to be adjusted.

*Ask your health care provider for a complete listing of foods high in sodium.

Monitor your fluid intake
If your doctor requires you to restrict your fluids, record the amount of liquids you drink/eat every day. You may need to restrict your fluids to 8¼ cups (which is equal to 2 liters OR 66 ounces) every 24 hours.

Recording your fluid intake will help ensure that you are not taking in more fluids than expected. It is a good idea to write this information on a calendar.

To record your fluid intake, you will need to learn the number of cc’s or ml’s in common servings. Some sample measurements are included in the box below.

Note that some foods, as listed below, are "fluid" foods:

Keep a record of daily fluid intake until you feel at ease with your fluid restriction and can figure out your fluid intake without measuring liquids.

One way to keep track of your fluid intake: Fill a 2-quart pitcher or 2-liter soda bottle to the top with water and place it in an accessible place in the kitchen. Every time you drink or eat something that is considered a fluid, remove the same amount of water from the pitcher/bottle. When the pitcher/bottle is empty, you have had your limit of fluids for the day.

Note: being thirsty does not mean your body needs more fluid. You need to be careful NOT to replace the fluids that diuretics (water pills) have helped your body get rid of. Here are some tips for decreasing thirst:

• Nibble on frozen grapes or strawberries
• Suck on ice chips (not cubes), a sucker or a washcloth soaked in ice-cold water
• Cover your lips with petroleum jelly, flavored lip balm or lip moisturizer
• Suck on hard candy or chew gum (sugarless)
• Avoid milk or ice cream products, as they increase thirst

Record your urine output, as recommended by your doctor. Recording your urine output will help ensure that you are not taking in more fluids than expected.

© Copyright 1995-2006 The Cleveland Clinic Foundation. All rights reserved

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional written health information, please contact the Health Information Center at the Cleveland Clinic (216) 444-3771 or toll-free (800) 223-2273 extension 43771 or visit www.clevelandclinic.org/health/.

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