An 87-year-old patient is admitted to the cardiac telemetry floor for exacerbation of congestive heart failure (CHF). The nurse assesses the patient and finds 3+ pitting edema to the lower extremities. Besides fluid intake restriction, the nurse should implement which of the following interventions?
•Patients with congestive heart failure (CHF) in exacerbation have fluid volume excess.
•In a patient with right-sided heart failure, the edema is seen peripherally, in the extremities and organs (hepatomegaly). In left-sided heart failure, the fluid backs up into the lungs, causing impaired gas exchange and breathing difficulties.
•These right-sided heart failure patients often have lower extremity edema. This swelling can make the legs sore and tender. The nurse can assist the patient to keep the legs elevated to reduce swelling.
•If the patient is wearing compression socks, these should be changed daily but kept in place to help reduce swelling.
•These patients should also maintain a diet with less than 2 grams of sodium intake in 24 hours.
•In left-sided heart failure, the legs should not be elevated, to avoid fluid backing up into the lungs.