21 hours ago This lab report was drawn on your patient who is taking aldosterone antagonist, such as Spironolactone (Aldactone). What is happening to the patients body? Electrolytes are being reabsorbed by the kidney causing levels to be too high >> Go To The Portal
Aldosterone antagonists are added to therapy for patients with worsening symptoms of HF. Aldosterone promotes myocardial remodeling and myocardial fibrosis, so aldosterone antagonists can help with this symptom. ARBs are given for patients who do not tolerate ACE inhibitors. Beta blockers do not prevent fibrotic changes. DRIs are not widely used.
Swelling of the tongue and hoarseness are the most common symptoms. 2. It appears to be related to the decrease in aldosterone production. 3. Presence of a dry, hacking cough indicates a high risk for this adverse response. 4. Because it takes time to build up a blood level, it occurs after being on the drug for about one week. 1.
The nurse finds a new laboratory report showing a plasma digoxin level of 0.7 ng/mL. What action should the nurse take? a. Withhold the drug for an hour and reassess the level. b. Withhold the drug and notify the prescriber immediately.
It’s known as hyperaldosteronism. Primary hyperaldosteronism could be caused by an adrenal tumor (usually benign, or noncancerous). Meanwhile, secondary hyperaldosteronism could be caused by a variety of conditions.
Aldosterone receptor antagonists block the effects of aldosterone, preventing the the reabsorption of sodium, which encourages water loss. This leads to a decrease in blood pressure and a reduction in fluid around the heart.
The pump acts to re-absorb sodium and water in exchange for potassium, which is then eliminated in the urine. Consequently, aldosterone antagonism can cause hyperkalemia. Hyperkalemia is an established adverse effect of both spironolactone and eplerenone. The symptoms of hyperkalemia begin with muscle weakness.
Aldosterone Antagonists, SelectiveAldactone.CaroSpir.eplerenone.finerenone.Inspra.Kerendia.spironolactone.
So, the correct answer is 'ANP'.
Aldosterone receptor antagonists block the effects of aldosterone. This causes reabsorption of sodium by the kidneys and other glands, which encourages water loss, and a subsequent decrease in blood pressure and reduction in fluid around the heart.
Aldosterone causes sodium to be absorbed and potassium to be excreted into the lumen by principal cells. In alpha intercalated cells, located in the late distal tubule and collecting duct, hydrogen ions and potassium ions are exchanged. Hydrogen is excreted into the lumen, and the potassium is absorbed.
The side effects of aldosterone antagonists include hyperkalemia, hyperchloremic metabolic acidosis, gynecomastia, acute renal failure, and kidney stones. Hyperkalemia, with the potential for cardiac arrest, is the most feared complication of aldosterone antagonists.
Why Is Aldosterone Important? It's a hormone that plays a big role in keeping your blood pressure in check. Aldosterone balances the levels of sodium and potassium in your body. It signals to your organs, like your colon and kidneys, to put more sodium into your bloodstream or release more potassium into your pee.
Aldosterone antagonists (spironolactone, eplerenone) also known as “potassium sparing diuretics” block the action of aldosterone inhibiting the reuptake of sodium and water. Normally, when sodium reabsorbed it is exchanged with potassium which is then excreted.
What hormone is antagonistic to the actions of aldosterone? How is the heart involved as an endocrine gland? A few cardiac cells secrete atrial natriuretic peptide (ANP), which helps regulate salt output by the kidney. ANP inhibits aldosterone and signals the kidney to remove more salt.
Examples of Antagonistic HormonesParathyroid hormone (PTH) and Calcitonin. Calcitonin and PTH are referred to as antagonistic hormones, as their actions are diametrically opposite. ... Glucagon and Insulin. Insulin and glucagon are antagonistic hormones.
Hormones that act to return body conditions to within acceptable limits from opposite extremes are called antagonistic hormones. The regulation of blood glucose concentration (through negative feedback) illustrates how the endocrine system maintains homeostasis by the action of antagonistic hormones.
A patient with Stage C heart failure (HF) who has been taking an ACE inhibitor, a beta blocker, and a diuretic begins to have increased dyspnea, weight gain, and decreased urine output. The provider orders spironolactone [Aldactone]. The nurse will instruct the patient to:
Spironolactone is a potassium-sparing diuretic with weak diuresis effects; it is used in conjunction with other diuretics to improve electrolyte balance. A patient newly diagnosed with heart failure is admitted to the hospital. The nurse notes a pulse of 90 beats per minute.
Treatment at this stage includes an ACE inhibitor and a beta blocker to help prevent the progression of symptoms. Biventricular pacemakers are used for patients in Stage C heart failure and have more advanced structural disease and symptoms. Dietary supplements and exercise have not been proven to prevent structural heart disease. Diuretics and digoxin are used for patients with Stage C heart failure.
Hyperkalemia, not hypokalemia, is a concern because of the decreased aldosterone release that occurs with blockage of angiotensin II. Click again to see term 👆. Tap again to see term 👆. A nurse is discussing heart failure with a group of nursing students.
Furosemide is a loop diuretic, which can produce profound diuresis very quickly even when the glomerular filtration rate (GFR) is low. An ACE inhibitor will not reduce fluid volume overload. Digoxin has a positive inotropic effect on the heart, which may improve renal perfusion, but this is not its primary effect. Spironolactone is a potassium-sparing diuretic with weak diuresis effects; it is used in conjunction with other diuretics to improve electrolyte balance.
A patient newly diagnosed with heart failure is admitted to the hospital. The nurse notes a pulse of 90 beats per minute. The nurse will observe this patient closely for:
A patient with chronic hypertension is admitted to the hospital. During the admission assessment, the nurse notes a heart rate of 96 beats per minute , a blood pressure of 150/90 mm Hg, bibasilar crackles, 2+ pitting edema of the ankles, and distension of the jugular veins. The nurse will contact the provider to request an order for which medication?
B. furosemide (Lasix) C. vitamin K. D. potassium supplements. D . potassium supplements. Potassium-sparing diuretics such as spironolactone are frequently combined with thiazide and loop diuretics to promote diuresis and to help counteract the potassium loss that may occur with thiazides/loop diuretics.
If postural hypotension occurs, the patient should reduce his or her activity level. A. Postural hypotension can be minimized by getting up slowly. Postural hypotension, marked by symptoms of dizziness and lightheadedness with position changes, can be minimized by getting up slowly.
As the nurse is assessing a patient who is taking a thiazide diuretic, the lab calls to report that the patient's serum potassium level is 5.9 mEq/L. Which diagnostic test should be scheduled in response to this finding?
A. Electrocardiogram (ECG) Hyperkalemia causes alterations in the ECG and cardiac rhythm and may lead to cardiac dysrhythmias or even cardiac arrest if the serum potassium level reaches 8 to 9 mEq/L.
Confusion, anxiety, weakness, and numbness or tingling of the hands and feet are possible signs of hyperkalemia. Intestinal dilation, ileus, and paralysis of skeletal muscle are signs of possible hypokalemia.
D. Ototoxicity. Furosemide can cause transient hearing loss, which is increased if other ototoxic drugs (such as gentamicin) are given at the same time. Combined use of these drugs should be avoided. A patient receiving digoxin (Lanoxin) is also taking a thiazide diuretic.
Furosemide, a high-ceiling (loop) di uretic, is useful in patients with severe renal impairment because it can promote diuresis in the presence of reduced glomerular filtration rate. Thiazides are not effective if renal impairment is present, and potassium-sparing diuretics have limited diuretic effects.
d. Thyroid replacement drugs require that a patient taking an oral antidiabetic drug be placed on insulin. a. Thyroid replacement drugs reduce the effectiveness of all antidiabetic drugs. A patient is prescribed levothyroxine (Synthroid) and a fiber supplement.
A patient is prescribed levothyroxine sodium (Synthroid) 25 mcg orally once a day. The pharmacy sends liothyronine sodium (Cytomel) 25 mcg. What is your best action?
a. Thyroid hormones are stored and thyroid suppressing drugs only stop the synthesis of new hormones. A patient who has been taking methimazole (Tapazole) for 3 weeks has all of the following laboratory blood test results.
c. "The thyroiditis will be cured with antibiotics and then you will no longer need the thyroid replacement drugs."
a. When underproduced, these hormones can lead to high blood pressure and stroke.
a. These drugs have a low likelihood of increasing the risks for birth defects.
The need for at least three drugs in the treatment regimen because of the complexity of angina in the older adult. 4. Those with higher risk for silent myocardial infarction (MI) 1. Consideration of risk factors for diseases associated with older adults.
3. Take one nitroglycerine tablet or spray at the first sign of angina; repeat every five minutes for no more than two doses. If chest pain is still not relieved, call 911. Combinations of a long-acting nitrate and a beta blocker are especially effective in treating angina because: 1.
1. They are useful to prevent stable angina because they decrease the thickening of vascular walls due to decreased modified release. 2. They are useful to prevent heart failure because they reduce remodeling of injured myocardial tissues. 3. Both 1 and 2 are true. 4.
3. Decreased renal function. Click again to see term 👆. Tap again to see term 👆. Angiotensin-converting enzyme (ACE) inhibitors are the drug of choice in treating hypertension in diabetic patients because they: 1. Improve insulin sensitivity. 2. Improve renal hemodynamics.
Ray has been diagnosed with hypertension and it is determined that an angiotensin-converting enzyme inhibitor is needed. Prior to prescribing this drug, the nurse practitioner (NP) should assess for:
Furosemide is added to a treatment regimen for heart failure that includes digoxin. Monitoring for this combination includes:
Angiotensin-converting-enzyme (ACE) inhibitors are a central part of the treatment of heart failure (HF) because they have more than one action to address the pathological changes in this disorder.
Hypoaldosteronism can be caused by: a diet very high in sodium (more than 2,300 mg/ day for those age 50 and under; 1,500 over age 50) congenital adrenal hyperplasia (a congenital disorder in which infants lack the enzyme needed to make cortisol, which can also affect ALD production)
An aldosterone (ALD) test measures the amount of ALD in your blood. It’s also called a serum aldosterone test. ALD is a hormone made by the adrenal glands. The adrenal glands are found on top of your kidneys and are responsible for producing several important hormones. ALD affects blood pressure and also regulates sodium (salt) ...
congenital adrenal hyperplasia (a congenital disorder in which infants lack the enzyme needed to make cortisol, which can also affect ALD production)
An ALD test is often used to diagnose endocrine disorders that can result in abnormalities with electrolytes and fluid. These may be caused by:
Your doctor may also ask you to: change the amount of sodium you eat (sodium restriction diet) avoid strenuous exercise. avoid eating licorice (licorice can mimic aldosterone properties) These factors can affect ALD levels.
It’s also important to remember that stress may also temporarily increase ALD. Posture is also important. You should be in the upright position for 2 hours prior to the test.
Medications that can affect ALD include: nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. diuretics (water pills) oral contraceptives (birth control pills)