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A sorbitol b water c an antacid d a laxative question

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A.SorbitolB.WaterC.An antacidD.A laxativeQuestion: Check your knowledgeWhich solution should the nurse administer with packed red blood cells?A.Lactated Ringer’s solutionB.0.9% sodium chlorideC.D5WD.0.45% sodium chlorideWeek 5Chapter 25Heart Failure DrugsHeart Failure (cont.)One of the most common causes for hospitalization in Canada5 000 annual deaths from heart failure
5-year survival rate in those with heart failure is 50%.Prevention is key.Heart 
FailureNotes-There are two types of heart failure* The heart is unable to pump blood in sufficient amounts from the ventricles to meet thebody’s metabolic needs* Symptoms depend on cardiac area affected-Left ventricular failure—elevated left ventricular pressure produces pulmonary edema(pulmonary congestion) resulting in cough, SOB & air hunger-Right ventricular failure—elevated right ventricular pressure leads to venouscongestion & peripheral edema i.e. edema of the ankles, jugular venous distention,ascites (abd distention) & hepatic congestionHeart Failure: CausesCardiac defectMIValve deficiencyDefect outside the heartCoronary artery diseasePulmonary hypertensionDiabetesSupraventricular dysrhythmiasAtrial fibrillation :Atrial flutterConduction System of the Heart
The New York Association’s Classification of Heart FailureClass INo physical activity limitationsClass IIOrdinary physical activity results in fatigue, dyspnea, or other symptoms.Class IIIMarked limitation in physical activityClass IVSymptoms at rest or with no physical activity at allDrug Therapy for Heart FailurePositiveinotropicdrugs: increase the force of myocardial contractionPositivechronotropicdrugs: increase heart ratePositivedromotropicdrugs: accelerate cardiac conduction (electrical impulse)Drug Therapy for Heart Failure (cont.)Positive inotropic drugsPhosphodiesterase inhibitorsCardiac glycosidesB-type natriuretic (increase the heart contraction ) peptidesOther drugs used in heart failureACE-inhibitorsAngiotensin II receptor blockers (ARBs)ß-BlockersDiuretics (removes the volume)Drugs of Choice for Early Treatment of Heart FailureACE Inhibitors (first)ARBs (second)Certain ß-blockers (bisoprolol, extended-release metoprolol tartrate, and carvedilol)Drugs of Choice for Early Treatment of Heart Failure
Loop diuretics(furosemide)are used to reduce the symptoms of heart failuresecondary to fluid overload.Aldosterone inhibitors (spironolactone, eplerenone)are added as heart failureprogresses.Only after these drugs are used is digoxin added.Drugs of Choice for Early Treatment of Heart Failuredobutamine: positive inotropic drughydralazine/isosorbidedinitrate recommended specifically for use in BlackpatientsACE InhibitorsPrevent sodium and water resorption by inhibiting aldosterone secretionDiuresis results, which decreases preload, or the left ventricular end volume, and thework of the heartExamples: lisinopril, enalaprillisinopril (Prinivil®, Zestril®)Uses: hypertension, heart failure, and acute myocardial infarctionAdverse Effects:HyperkalemiaDry coughDecreased renal functionAngiotensin II Receptor BlockersPotent vasodilators; decrease systemic vascular resistance (↓afterload)Used alone or in combination with other drugs such as diuretics in the treatment ofhypertension or heart failure

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