Heart Failure Monitoring Worksheet - Tufts University

Month   o f   _ ________________  

 

Heart   F ailure   M onitoring   W orksheet  

 

 

 

Respiratory  

Furosemide   D ose  

Day  

Appetite  

Comments  

Rate/Minute  

AM                               P M  

1   t ab  

½   t ab  

e.g.,   “ Breathing   b etter   t oday”   o r   “ Gave   e xtra  

Sample  

32  

Excellent       X   G ood     Fair       Poor  

(or   1 2.5   m g)  

(or   6 .25   m g)  

furosemide   ½   t ablet”  

1  

 

 

 

Excellent       Good     Fair       Poor  

 

2  

 

 

 

 

Excellent       Good     Fair       Poor  

3  

 

 

 

Excellent       Good     Fair       Poor  

 

4  

 

 

 

Excellent       Good     Fair       Poor  

 

5  

 

 

 

 

Excellent       Good     Fair       Poor  

6  

 

 

 

Excellent       Good     Fair       Poor  

 

7  

 

 

 

 

Excellent       Good     Fair       Poor  

8  

 

 

 

 

Excellent       Good     Fair       Poor  

9  

 

 

 

Excellent       Good     Fair       Poor  

 

10  

 

 

 

 

Excellent       Good     Fair       Poor  

11  

 

 

 

Excellent       Good     Fair       Poor  

 

12  

 

 

 

 

Excellent       Good     Fair       Poor  

13  

 

 

 

 

Excellent       Good     Fair       Poor  

14  

 

 

 

Excellent       Good     Fair       Poor  

 

15  

 

 

 

 

Excellent       Good     Fair       Poor  

16  

 

 

 

 

Excellent       Good     Fair       Poor  

17  

 

 

 

Excellent       Good     Fair       Poor  

 

18  

 

 

 

 

Excellent       Good     Fair       Poor  

19  

 

 

 

Excellent       Good     Fair       Poor  

 

20  

 

 

 

 

Excellent       Good     Fair       Poor  

21  

 

 

 

 

Excellent       Good     Fair       Poor  

 

22  

 

 

 

Excellent       Good     Fair       Poor  

23  

 

 

 

 

Excellent       Good     Fair       Poor  

24  

 

 

 

 

Excellent       Good     Fair       Poor  

25  

 

 

 

Excellent       Good     Fair       Poor  

 

26  

 

 

 

 

Excellent       Good     Fair       Poor  

27  

 

 

 

Excellent       Good     Fair       Poor  

 

28  

 

 

 

 

Excellent       Good     Fair       Poor  

29  

 

 

 

 

Excellent       Good     Fair       Poor  

30  

 

 

 

Excellent       Good     Fair       Poor  

 

31  

 

 

 

Excellent       Good     Fair       Poor  

 

 

Respiration   R ate:     C ount   t he   n umber   o f   b reaths   f or   3 0   s econds   a nd   m ultiply   t imes   2   t o   g et   t he   r espiratory   r ate   p er   m inute.   I n   d ogs,   o btain  

the   r espiratory   r ate   w hen   t hey   a re   a t   r est   a nd   n ot   p anting.   I n   c ats   g et   t he   r espiratory   r ate   a t   r est   w hen   t hey   a re   n ot   p urring.   I n   a nimals   w ith  

well   c ontrolled   h eart   f ailure   t he   b reathing   r ate   i s   o ften   l ess   t han   3 5-­‐40   b reaths   p er   m inute.   W hen   t he   b reathing   r ate   i s   c limbing,   o r   w hen  

there   i s   m ore   e ffort   t o   t he   c hest   w all   o r   b elly   m uscles   d uring   b reathing,   t hen   f luid   i s   l ikely   a ccumulating   i n   t he   l ungs   a nd   m ore   f urosemide  

may   b e   i ndicated.   P lease   b ring   t his   s heet   w ith   y ou   t o   y our   n ext   v eterinary   e xam.