Professional Documents
Culture Documents
Activity On Heart Failure Drugs and Diuretics
Activity On Heart Failure Drugs and Diuretics
HEART FAILURE
DRUGS AND
DIURETICS
CASE
AS,
CASE (cont.)
Her
PHYSICAL EXAMINATION
Vital signs:
BP 160/100
Pulse 90 bpm
RR 28 breaths/min
511
Weight: 78 kg
(+) distended neck
veins
Cardiac Examination:
Height:
MEDICATION HISTORY
Current
medications:
Hydrocholorothiazide 25 mg/day
Ibuprofen 600 mg/4x a day
Ranitidine 150 mg every night at bed
time
Citalopram 20 mg/day
41.1%
5300/ul
Na
132 mEq/L
3.2 mEq/L
Cl
100 mEq/L
HCO3
30 mEq/L
Mg
1.5 mEq/L
FBS
100 mg/dL
Uric Acid
BUN
8 mg/dL
40 mg/dL
0.8 mg/dl
AlkPhos
44 units/l
AST
30 units/L
BNP
TSH
2 microunits/mL
PATIENT PROBLEMS
WITH BASES
ANKLE EDEMA
A
in recumbent position
A later manifestation of heart failure
Results from redistribution of fluid from the
splanchnic circulation and lower extremities into
the central circulation during recumbency w/
resultant increase in pulmonary capillary
pressure
Relieved by sitting upright or sleeping with
additional pillows
Nocturnal cough is a common manifestation of
this process
PHYSICAL EXAMINATION
Vital signs:
BP 160/100
Pulse 90 bpm
RR 28 breaths/min
511
Weight: 78 kg
(+) distended neck
veins
Cardiac Examination:
Height:
PHYSICAL EXAMINATION
Vital signs:
BP 160/100
Pulse 90 bpm
RR 28 breaths/min
BP:
Hypertensive
Pulse rate: Normal
RR: Tachypneic
PHYSICAL EXAMINATION
Vital signs:
BP 160/100
Pulse 90 bpm
RR 28 breaths/min
Height:
511
Weight: 78 kg
(+) distended neck
veins
Provides
estimation for
right atrial pressure
Indicate presence of
tricuspid regurgitation
PHYSICAL EXAMINATION
Evident
in patients
with enlarged and
hypertrophied
right ventricles
Signifies volume
overload
Cardiac
Examination:
PHYSICAL EXAMINATION
Cardiac
Important
sign in
patients with heart
failure; may pulsate
during systole if
tricuspid regurgitation
is present
Later can cause ascites
due to increase
pressure in the hepatic
veins and veins
draining the
peritoneum
Examination:
PHYSICAL EXAMINATION
Cardiac
Examination:
Distention
of neck
veins by the
maneuver of firm
pressure over the
liver
See in tricuspid
regurgitation
PHYSICAL EXAMINATION
Chest