Exam (elaborations)
Treatment of Heart Failure.
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- MedSurg Notes Nurse’s Clinical Pocket Guide
Treatment of Heart Failure.
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Treatment of Heart FailureAction of the kidney in response to a decrease in blood volume? - ANS-Regulation of its
own blood volume by secretion of renin to increase blood volume.
Actions of Beta-blocker in Heart Failure - ANS-1. Reduce heart failure
2. Improve diastolic filling (preload)
3. Increases coronary flow
4. Reduce risk of arrythmias
Adverse effects of Aldosterone Antagonists - ANS-1. Worsening of renal function due to
dehydration
2. Fall in blood pressure
3. Blocking of aldosterone can result in high potassium concentration (hyperkalaemia)
4. Anti-androgenic effect (result in gynaecomastia)
Adverse effects of Loop Diuretics - ANS-1. Polyuria, frequency and incontinence
2. Cause electrolyte losses (increase loss of Mg2+, and Ca2+ due to direct effect on
TAL, as well as K+ and H+ due to increased delivery of distal tubule).
3. Severe dehydration
4. Postural hypotension (major decrease in blood volume)
5. Allergic reactions
Difference in monitoring between renin-angiotensin agents compared to beta blockers?
- ANS-No need to monitor kidney function and potassium levels as these factors are not
affected by changing catecholamine levels (beta blockers)
Dose of beta of blockers are increased until? - ANS-1. Systolic BP falls to 90-100
2. Heart rate is below 60 bpm
3. Achieve maximum recommended dose
Functions of renin-angiotensin agents in heart failure? - ANS-1. Lower afterload
(decrease cardiac workload)
2. Less salt and water retention (decrease blood volume = decrease BP)
3. Reduced arteriolar constriction (decreased BP)
High levels of catecholamines is ... ? - ANS-Maladaptive - down regulation of
beta-receptors in the heart resulting in decreased sensitivity.
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