Describe each of the components of nutrition intervention for heart failure, including sodium restriction, energy and protein requirements, fluid intake, and drug-nutrient interactions
A 2000-mg sodium diet is a standard initial recommendation for individuals with HF. Adjustments to levels of 2000 mg, 1000 mg, or 500 mg may be prescribed depending on the patient's individual medical condition—specifically, fluid and volume states as well as overall oral intake. Energy needs should be determined by indirect calorimetry. Daily protein intake should be 1.13 g/kg of body weight for patients in a nourished state or 1.37 g/kg for those in a stable malnourished state. Fluid requirements are typically calculated at 1mL/kcal or 35 mL/kg. For HF, fluid is restricted to less than 2000 mL/day for a serum sodium below 130 mEq/L. The use of multiple diuretics in the medical treatment of HF may lead to losses of multiple water-soluble nutrients, including potassium, magnesium, thiamin, riboflavin, folate, and vitamin B12.
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