It’s important to ask the right questions when assessing your patients with heart failure (HF). Patients do not always identify or report common and atypical signs and symptoms of HF and may not understand that these may reflect a worsening clinical status. Albert and colleagues examined the prevalence of HF signs and symptoms relative to demographics, care setting, and functional class. They concluded that nurses must recognize atypical signs and symptoms of worsening functional class to determine clinical status and facilitate patient care decisions. They found the following:
Nearly all patients reported dyspnea regardless of functional class, therefore it is not a sensitive marker of worsening functional status.
When patients used a checklist format of HF signs and symptoms, it prompted them to report all signs and symptoms they were experiencing, rather than only those they thought were related to HF.