Heart failure: Watching your fluids

Fluid usually is not restricted in heart failure unless you have advanced or severe heart failure. Usually, restricting sodium intake alone is enough to help your body get rid of extra fluids.

But if your doctor recommends that you limit the amount of fluids you drink and eat (fluid intake), you will need to keep track of all beverages and any foods that contain a lot of liquid. Your doctor will tell you how much fluid you can have in a day.

Test Your Knowledge

1. Fluid intake usually is not restricted in heart failure unless your doctor gives you a specific fluid limit.

   1. True

      This answer is correct.

      Fluid intake usually is not restricted in heart failure unless your doctor gives you a specific fluid limit. Usually fluid is not restricted unless you have severe or advanced heart failure.

   2. False

      This answer is incorrect.

      Fluid intake usually is not restricted in heart failure unless your doctor gives you a specific fluid limit. Usually fluid is not restricted unless you have severe or advanced heart failure.

Too much fluid in your body can make it harder for your already-weakened heart to pump and can make the symptoms of heart failure worse. Things that affect the amount of fluid in your body include:

• Too much sodium, which will cause your body to hold onto (retain) extra fluid. Following a low-sodium diet is important in preventing too much fluid from building up in your body.
• Diuretics, which help your body get rid of excess fluid.
• The amount of fluid you drink, especially if you cannot get rid of the extra fluid by limiting sodium and taking medicines.

Test Your Knowledge

1. It is important to follow your fluid recommendations in heart failure:

   1. So that you can eat more salt.

      This answer is incorrect.

      Following your fluid recommendations does not mean that you can eat more salt. If your doctor recommends that you limit your fluid intake, it is to help reduce the buildup of extra fluid in your body, along with the medicines you are taking and a low-sodium (low-salt) diet. The correct answer is b.

   2. Because it can help maintain a normal sodium balance.

      This answer is correct.

      Following your fluid recommendation is important in heart failure because it can help maintain a normal sodium balance. It may also help reduce the buildup of extra fluid in your body, along with the medicines you are taking and a low-sodium (low-salt) diet.

   3. So that you don't have to keep track of the sodium in your diet.

      This answer is incorrect.

      Following your fluid recommendations does not mean that you don't have to keep track of the sodium in your diet. If your doctor recommends that you limit your fluid intake, it is to help reduce the buildup of extra fluid in your body, along with the medicines you are taking and a low-sodium (low-salt) diet. The correct answer is b.

   4. So that you can quit taking your medicines.

      This answer is incorrect.

      Following your fluid recommendations does not mean that you can quit taking your medicines. If your doctor recommends that you limit your fluid intake, it is to help reduce the buildup of extra fluid in your body, along with the medicines you are taking and a low-sodium (low-salt) diet. The correct answer is b.

Your doctor will tell you how much fluid you should be taking in every day. Recommendations may range from about 1500 mL (1.6 qt) to 2000 mL (2 qt), or about 48 fl oz (1420 mL) to 64 fl oz (1893 mL) a day. Here are the amounts of fluid in some common equivalent household measures:

It is important to know how much fluid your regular drinking glasses hold. You can find out by filling your drinking glass with water and then measuring the amount in a measuring cup. Once you know this, you won't have to measure every time.

Besides water, milk, juices, and other beverages, some foods contain a lot of fluid. Any foods that will melt (such as ice cream, gelatin, or flavored ice treats) or foods that have a lot of liquid (such as soup) should also be measured and counted as part of your fluid intake.

How to keep track of your fluid intake

One method for keeping track of your fluid intake is to have an empty container that holds the amount of fluid you are allowed for the day. As you drink fluids, put an equal amount of water into the container until you reach your fluid limit. When the container is full, you have reached your fluid limit and should stop drinking.

Another method for keeping track of your fluid intake is to allow yourself 8 fl oz (1 cup) of fluid at each meal [3 x 8 fl oz = 24 fl oz, or 3 cups]. You can then fill a container with water to keep in your refrigerator that contains the balance of your fluid allowance. For example, if you are allowed 48 fl oz (6 cups) of fluid a day, you could have 24 fl oz (3 cups) divided into three meals and then another 24 fl oz (3 cups) in the refrigerator to drink during the day. If you drink other beverages besides water (such as coffee, juice, or soft drinks), then you would need to pour out an equal amount of water from your container in the refrigerator.

Test Your Knowledge

1. To keep track of your fluid intake, you should:

   1. Estimate how much you drink during the day.

      This answer is incorrect.

      To keep track of your fluid intake, you should not estimate how much you drink during the day. It is important to carefully measure the amount of any fluids you drink as well as the fluid in foods, such as ice cream, gelatin, flavored ice treats, and soup. Estimating fluid intake can be very inaccurate. The correct answer is c.

   2. Keep track of only the water you drink.

      This answer is incorrect.

      To keep track of your fluid intake, you should not keep track of only the water you drink. It is important to measure the amount of any fluids you drink as well as the fluid in foods, such as ice cream, gelatin, flavored ice treats, and soup. Estimating fluid intake can be very inaccurate. The correct answer is c.

   3. Measure all beverages and all foods that have a lot of fluid in them.

      This answer is correct.

      To keep track of your fluid intake, you should measure all beverages and all foods that have a lot of fluid in them. It is important to measure the amount of any fluids you drink as well as the fluid in foods, such as ice cream, gelatin, flavored ice treats, and soup. Estimating fluid intake can be very inaccurate.

   4. Drink only at meals.

      This answer is incorrect.

      To keep track of your fluid intake, you should not drink only at meals. It is important to measure the amount of any fluids you drink as well as the fluid in foods, such as ice cream, gelatin, flavored ice treats, and soup. Estimating fluid intake can be very inaccurate. The correct answer is c.

2. Which is equal to 1 fluid quart?

   1. 8 fluid ounces

      This answer is incorrect.

      Eight fluid ounces is not equal to 1 quart. Thirty-two fluid ounces is 1 quart. It is important to measure fluids and to know how much fluid your glasses hold. The correct answer is c.

   2. About 15 milliliters, or 1/2 fluid ounce

      This answer is incorrect.

      About 15 milliliters, or 1/2 fluid ounce, is not equal to 1 quart. One liter is about 1 quart. It is important to measure fluids and to know how much fluid your glasses hold. The correct answer is c.

   3. About 1 liter, or 32 fluid ounces

      This answer is correct.

      One liter is about 1 quart, or 32 fluid ounces. It is important to measure fluids and to know how much fluid your glasses hold.

   4. About 125 milliliters, or 4 fluid ounces

      This answer is incorrect.

      About 125 milliliters is not equal to 1 quart. Thirty-two fluid ounces is 1 quart. It is important to measure fluids and to know how much fluid your glasses hold. The correct answer is c.

Talk with your health professional (cardiologist, family doctor, dietitian, or nurse)

If you have questions about this information, take it with you when you visit your health professional. You may want to mark areas or make notes in the margins of the pages where you have questions.

If you would like more information on fluid intake in heart failure, the following resource is available:

Organization