Heart failure edema

Sodium is contraindicated in patients with hypernatremia, fluid retention, and when the administration of sodium or chloride could be detrimental. Sodium is used cautiously in surgical patients and those with circulatory insufficiency, hypoproteinemia, urinaiy tract obstruction, congestive heart failure, edema, and renal impairment. Sodium is a Pregnancy Category C drug and is used cautiously during pregnancy. 

Peripheral edema is a cardinal finding in heart failure. Edema usually occurs in dependent parts of the body and thus is seen as ankle or pedal edema in ambulatory patients, although it may be manifested as sacral edema in bedridden patients. Adults typically have a 10-lb fluid weight gain before trace peripheral edema is evident therefore, patients with acute heart failure may have no clinical evidence of systemic congestion except weight gain. 

Diuretics are used to treat HTN, heart failure, edema, renal dysfunction, hypercalcemia, renal stones, glaucoma, and mountain sickness. In addition to their diuretic action, the loop and thiazide diuretics also cause vasodilation. 

The response to diuretics is often impaired in patients with CHF. This impaired response may itself be a manifestation of the Na avidity and the volume retention that characterize advanced heart failure. While there may initially be a brisk response to once-daily dosing, a compensatory increase in Na reabsorption during the remainder of the day may prevent effective diuresis as a result, reduction of the dosing interval may be warranted. In advanced heart failure, edema. 

Cardiovascular system congestive heart failure, edema, aggravation of hypertension, hypotension. 

Symptoms similar to those of chronic right-sided heart failure (edema, ascites, and hepatomegaly). 

The side effects and toxic reactions to verapamil iaclude upper GI upset, constipation, di22iaess, headaches, flushing and burning, edema, hypotension, bradycardia, and various conduction disturbances. Verapamil has negative iaotropic activity and may precipitate heart failure ia patients having ventricular dysfunction (1,2). 

Moreover, digitahs has indirect effects on the circulation, which in normal hearts results in a small increase in arterial pressure, peripheral resistance, and cardiac output (114). The effects of digitahs on the circulation of an individual experiencing congestive heart failure are much more dramatic, however. The increased cardiac output, for example, increases renal blood flow which can reheve in part the edema of CHF associated with salt and water retention (114). 

Diuretics are one of the dmg categories most frequendy prescribed. The principal uses of diuretics are for the treatment of hypertension, congestive heart failure, and mobilization of edema fluid in renal failure, fiver cirrhosis, and ascites. Other applications include the treatment of glaucoma and hypercalcemia, as well as the alkafinization of urine to prevent cystine and uric acid kidney stones. 

If the drug is given is given to treat congestive heart failure (ie, carvedilol), the patient is assessed for evidence of the disease, such as dyspnea (especially on exertion), peripheral edema, distended neck veins, and cough. 

Immediately report any signs of congestive heart failure (weight gain, difficulty breathing, or edema of die extremities). 

Mild diarrhea and itching have been reported with the administration of vitamin B12. Other adverse reactions that may be seen include a marked increase in RBC production, acne, peripheral vascular thrombosis, congestive heart failure, and pulmonary edema... 

A diuretic is a drug that increases die secretion of urine (ie, water, electrolytes, and waste products) by die kidneys. Many conditions or diseases, such as heart failure, endocrine disturbances, and kidney and liver diseases can cause retention of excess fluid (edema). When die patient shows signs of excess fluid retention, die primary healdi care provider may order a diuretic. There are various types of diuretic drugs, and the primary healdi care provider selects the one that best suits die patient s needs and effectively reduces the amount of excess fluid in body tissues. 

TH E PATIEN T WITH ED EM A. Fhtients with edema caused by heart failure or other causes are weighed daily or as ordered by the primary health care provider. A daily weight is taken to monitor fluid loss. Weight loss of about 2 lb/d is desirable to prevent dehydration and electrolyte imbalances. The nurse carefully measures and records the fluid intake and output every 8 hours. The critically ill patient or the patient with renal disease may require more frequent measurements of urinary output. The nurse obtains the blood pressure, pulse, and respiratory rate every 4 hours or as ordered by the primary health care provider. An acutely ill patient may require more frequent monitoring of the vital signs. 

Cardiovascular system—hypertension, edema, congestive heart failure, and thromboembolism ... 

Thiamin deficiency can result in three distinct syndromes a chronic peripheral neuritis, beriberi, which may or may not be associated with heart ilure and edema acute pernicious (fulminating) beriberi (shoshin beriberi), in which heart failure and metabolic abnormalities predominate, without peripheral neuritis and Wernicke s encephalopathy with KorsakofPs psychosis, which is associated especially with alcohol and dmg abuse. The central role of thiamin diphosphate in... 

Nicardipine 1-A hour 5-10 minute 2.5-15 mg/hour Tachycardia, headache, heart failure, flushing, peripheral edema Long half-life, precluding rapid titration... 

Direct Vasodilators Isosorbide dinitrate 20 mg and hydralazine 37.5 (BiDil) 1-2 tablets three times a day Minoxidil (Loniten) Hydralazine Heart failure (isosorbide dinitrate + hydralazine in African-Americans) A-HeFT66 Edema (minoxidil) Tachycardia Lupus-like syndrome (hydralazine) ... 

Cardiovascular Worsening hypertension, edema, dyslipi-demia, left ventricular hypertrophy, electrocardiographic changes and chronic heart failure. 

Medications can increase the risk of hyperkalemia in patients with CKD, including angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers, used for the treatment of proteinuria and hypertension. Potassium-sparing diuretics, used for the treatment of edema and chronic heart failure, can also exacerbate the development of hyperkalemia, and should be used with caution in patients with stage 3 CKD or higher. 

Thiazolidinediones may produce fluid retention and edema however, the mechanism by which this occurs is not completely understood. It is known that blood volume increases approximately 10% with these agents, resulting in approximately 6% of patients developing edema. Thus, these drugs are contraindicated in situations in which an increased fluid volume is detrimental, such as heart failure. Fluid retention appears to be dose-related and increases when combined with insulin therapy. 

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