Dietetics — Advice Letter for a Patient with Heart Failure on a Fluid and Salt Restriction
A hospital dietitian writes an advice letter to a 69-year-old man newly diagnosed with heart failure explaining the fluid restriction to 1.5 litres per day and a sodium target of 2 g/day. The intermediate challenge is translating clinical targets into practical daily instructions the patient can follow at home.
Letter type
Advice
Write to
Patient
Target length
190–210 words
The case notes
Patient: Mr Bernard Okafor, 69 years old; newly diagnosed heart failure (EF 35%)
Fluid restriction: Total fluid intake: 1.5 L per day (all liquids: water, tea, coffee, soup, ice cream, jelly — anything liquid at room temperature counts)
How to measure: Use a measuring jug in the morning; pour the day's 1.5 L allowance; every cup taken out of the jug; this method avoids losing count
Sodium restriction: Target: 2 g sodium per day (~5 g salt); stop adding salt at the table or during cooking; avoid processed meats, canned soups, ready meals, soy sauce, stock cubes — these are high in hidden sodium; use herbs and spices instead
Daily weighing: Weigh every morning before eating and after going to the toilet; record in diary; if weight increases more than 2 kg in 2 days — contact the GP or heart failure nurse immediately (fluid retention sign)
Foods to be aware of: Alcohol counts toward fluid limit; carbonated drinks are high in sodium and count toward fluid; avoid liquorice (can worsen fluid retention)
Why restrictions are important: Fluid and salt cause the body to retain water; in heart failure this puts extra strain on the heart and causes swelling of legs and breathlessness
Task: Write an advice letter to Mr Okafor explaining his fluid and sodium restrictions and how to monitor himself at home.
Writing task
Write an advice letter to Mr Okafor explaining his fluid and sodium restrictions and how to monitor himself at home.
What to include, what to cut
The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.
Include
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The 1.5 L fluid limit including all liquids — and the measuring jug method
Patients frequently undercount fluids by not including soups, ice cream, or sauces. The measuring jug method is the most reliable practical tool for compliance with a fluid restriction.
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The daily weigh-in and the 2 kg in 2 days trigger
This converts a clinical concept (fluid retention) into an actionable home monitoring protocol. The patient does not need to recognise fluid retention in the abstract — they need a specific number that prompts them to call.
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The three highest-sodium food categories to avoid: processed meats, canned soups, ready meals
A categorical approach is more actionable than a long food list. These three categories account for the majority of hidden dietary sodium and are the patient's highest-priority targets.
Leave out
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A detailed pathophysiology explanation of heart failure
One plain-language sentence is enough: 'Too much fluid and salt make the heart work harder and cause swelling and breathlessness.' This motivates compliance without the clinical lecture.
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The specific medications the patient is on
Managed by the cardiology and GP team. The dietary advice letter focuses on the dietary management. One sentence — 'your medications are prescribed separately by your cardiologist' — is enough if any reference is needed.
Criterion in focus · Conciseness & Clarity
Heart failure dietary advice letters are assessed on whether the patient can derive an actionable daily routine from the letter. The measuring jug method, the morning weigh-in, and the 2 kg trigger are three concrete behaviours. 'Monitor your fluid and salt intake carefully' is not actionable. 'Pour 1.5 litres into a jug each morning and only drink from that jug' is.
Now write the letter — and find out what is blocking your Grade B
Write a 190–210 words advice letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $12.