By what mechanism do loop diuretics reduce pulmonary and peripheral edema?
a)Increasing the sodium concentration within the urine b)Promoting fluid movement from the interstitial spaces to the vascular space c)Decreasing preload in the heart d)Increasing urinary output
Promoting fluid movement from the interstitial spaces to the vascular spaceExplanation:
All of the above play a role in the mechanism of action of diuretics. Loop diuretics are used to decrease fluid volume and edema present in CHF. In general, diuretics act in the nephrons of the kidney to increase urinary output and electrolyte loss. This action decreases circulating volume and peripheral resistance, reducing the workload on the failing heart. Removal of fluid from the vascular space allows mobilization of edema from the interstitial spaces. With less volume in the vascular space, less blood is returned to the heart (decreased preload) and cardiac output is decreased. (less)
The pre-administration physical assessment for cardiotonic drugs should include which of the following? Select all that apply:
In a discussion of heart failure, the nursing instructor is explaining preload and afterload. Which of the following statements regarding preload and afterload is accurate?
a)Afterload is related to the ejection of blood from the ventricle, and preload is related to the filling of the ventricle. b)Preload is related to the ejection of blood from the ventricle, and afterload is related to the filling of the ventricle. c)Preload is related to the filling of the right ventricle, and afterload is related to the filling of the left ventricle. d)Preload is related to the filling of the left ventricle, and afterload is related to the filling of the right ventricle.
Preload is the filling pressure of the ventricle. Afterload is the pressure associated with the ejection of blood from the ventricle.
Which of the following is the result of positive inotropic activity? (Choose one)
Normal serum potassium level is 3.5 to 5.0. Therefore Options A, C, and D are incorrect.
A patient presents to the Emergency Department (ED) with rales, wheezing, and blood-tinged sputum. The nurse suspects the patient is in congestive heart failure (CHF). What would the nurse suspect the patient is experiencing?
In left sided heart failure, the left ventricle pumps inefficiently. Blood backs up into the lungs causing pulmonary vessel congestion and fluid leaks into the alveoli and lung tissue. In severe cases pulmonary edema occurs. The patient will present with rales, wheezes, blood-tinged sputum, low oxygenation, and development of a third heart sound. Cardiomyopathy can occur as a result of a viral infection, alcoholism, anabolic steroid abuse, or a collagen disorder. It causes muscle alterations and ineffective contraction and pumping. Cardiomegaly is an enlargement of the heart due to compensatory mechanisms in CHF and leads to ineffective pumping and eventually to increased CHF. Valvular heart disease leads to an overload of the ventricles because the valves do not close adequately causing blood to leak backward into the ventricles. This causes muscle stretching and increased demand for oxygen and energy.