MEDICAL NUTRITION THERAPY HEART FAILURE MODULE
Please answer questions concisely, with focus on nutritional implications.
1. Define the following terms:
• Blood pressure – the force of blood that is pushing against walls of the arteries
• Cardiac cachexia- weight loss that provoked by heart disease.
• Diastolic blood pressure- pressure of the blood in the blood vessels during diastole.
• Dry weight- person`s weight without any sodium and fluid in his body
• Ejection fraction (EF)- it is the blood fraction that located in the left and right ventricles and pumped out into the cardiac cycle
• Systolic blood pressure- blood pressure during systole (heartbeat)
• Wet weight- person`s weight with fluid in his body
2. What is the difference
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Therefore, compensated heart failure occurs when blood accumulates after the heart contraction that’s means at a higher venous pressure. In case when sympathetic discharge cannot change cardiac output easily and use renal mechanism to restore cardiac output decompensated heart failure occurs. Therefore the main difference between compensated heart failure and decompensated heart failure is in the action of sympathetic discharge that is regulated by sympathetic nervous system. (Cindy L. Stanfield.,2011.)
3. What is the difference between systolic and diastolic heart failure?
The main difference between systolic (SHF) and diastolic heart failure (DHS) is that during SHF decreased myocardial contractility occurs and causes reduced ejection fraction of the left ventricle. Therefore, to maintain cardiac output left ventricle is dilated during SHF. Despite SHF during DHF ejection fraction of the left ventricle is maintained, but there is no dilation of the left ventricle, decreased amount of blood enters the heart during diastole.
A. What is the Ejection Fraction (EF) and
B. What %EF distinguishes systolic from diastolic heart failure?
Ejection Fraction – is the quantity of blood that is pumped out from the left and right ventricles during after each heart
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High amount of liquid intake can lead to complications of CHF as it makes harder to your heart to pump. Fluid restriction and prescribed diuretics can help to decrease excess amount of fluid inside the body and facilitate pumping of the heart to support the body with oxygen and nutrients. (Kathleen L. Grady,2000.)
5. Name the major electrolyte abnormalities associated with diuretic use.
• Why does this happen?
• Does it always happen? Why or why not?
The most common electrolyte abnormalities after diuretic treatment include hyponatraemia, hypokalaemia. The reason is that diuretics help to excrete excess fluid from the body that contains both water and electrolytes. Therefore, diuretics prevent normal absorption of the electrolytes and different electrolyte abnormalities occur. It is approved that diuretics have such side effects as electrolyte abnormalities, but they are not manifested in 100% of cases. For example potassium loss occurs when patient have pre – existing hypokalaemia or have high dose and long-term diuretics treatment. (J A Clayton,2006)
6. List the 3 diuretics that can cause the electrolyte abnormality.
Thiazides: bendroflumethiazide, hydrochlorothiazide. Loop diuretics:
Cardiomyopathy can occur from the lack of dystrophin on the heart muscles. Cardiomyopathy makes it difficult for the patient to breathe. The heart becomes weak and swollen. It is not able to pump enough blood throughout the body, which will cause life-threatening results.
1.Congestive Heart Failure also known as (heart failure) is a life threatening condition. Heart Failure is caused when someone has a weak heart. It usually happens when the bodies blood pump to the heart is not pumping blood to the heart correctly.
4.1. Vasovagal Causes. 4.2. Orthostatic hypotension. 4.3.
If a patient cannot tolerate ACE inhibitors medication, vasodilators are also an option (Macon B.). Beta-Blockers can help reduce the blood pressure and slow down the rhythm of the heart (Macon, B.). Since a heart failure may cause the body to have more fluid than it should, diuretics may be used to reduce the fluid content in the
Systolic and Diastolic Heart Failure Heart failure occurs when the heart cannot pump enough blood for the body due to a weakened or damaged heart. The heart 's pumping action moves oxygen-rich blood as it travels from the lungs to the left atrium, then on to the left ventricle, which pumps it to the rest of the body. The left ventricle supplies most of the heart 's pumping power, so it 's larger than the other chambers and essential for normal function. (American Heart Association). In left-sided or left ventricular heart failure, the left side of the heart must work harder to pump the same amount of blood.
The cardiovascular system is broken down into two circulatory pathways: systemic circulation and pulmonary circulation. Systemic circulation carries oxygenated blood away from the heart to the body or organs, and then returns deoxygenated blood to the heart. Whereas the pulmonary circulation transports deoxygenated blood from the body or organs to the right side of the heart to the lungs and return oxygenated blood to the left side of the heart (Marieb, Nicpon, and Hoehn, 2013). The cardiac cycle consists of an ejection and a filling stage: systole and diastole, respectively. During the diastolic phase the heart ventricles are relaxed as the heart fills with blood, and blood pressure is the lowest; during the systolic phase the heat ventricles contract and pump blood out of the arteries, and blood pressure is increasing.
The study screened patients who were admitted to the Jewish Hospital which is located in the Washington University Medical Center. All the patients who were screened for the study were 70 years or older. The methods used for diagnosis of heart failure involved individuals who exhibited typical signs of heart failure and were responsive to diuress. Radiography for pulmonary congestion was also used. Additionally, patients with heart failure who had either prior history, or congestive heart failure as a result of uncontrolled hypertension or myocardial infraction, or had been readmitted more than four times in the past were eligible.
All of our cells, organs and tissues depend on water to help regulate homeostasis. Homeostasis is when our cells seek and maintain a condition of equilibrium or stability internally as it deals with environmental external changes. Because water plays many important roles in the overall maintenance of the body, some of the functions of it include: regulates body temperature, carries nutrients and oxygen to cells, lubricates joints, helps dissolve minerals and other nutrients , and most importantly it also moistens tissues like the mouth, eyes and nose. Dehydration is when the body is deficient in water. Because the water in our bloodstream plays an important role in equally transporting cells and minerals throughout the body, when an individual is not getting enough water the cells in the body will begin to shrivel up and malfunction.
Bradycardia is when the heart beat is slower than normal 21. Cardioplegia is a procedure that is used to stop the heart activity for a short period of time. This type of procedure is used for heart surgeries. 22. Cardiomyopathy is heart muscle disease that causes the muscle to become enlarged and stiff.
Congestive Heart Failure Acute Decompensated Heart Failure (ADHF) is a clinical syndrome of worsening signs or symptoms of heart failure requiring hospitalization or other unscheduled medical care (Felker 2014). ADHF formerly known as congestive heart failure is one of the leading cause for hospitalizations in the United States. ADHF accounts for approximately 1 million hospitalizations per year in the United States (Arnold & Porepa 2012). According to the Acute Decompensated Heart Failure National Registry, patients hospitalized with ADHF have a substantial risk of in-hospital mortality and rehospitalization. Pathophysiology
causes of peripheral edema in patients with heart failure are related to compensatory changes that influence hydrostatic pressure and fluid retention? (Cooper 2011). Input and Output need to be monitored ? accurate measuring for intake and output is important for the client with fluid overload.? (Metheny 2010).
Fluid can be lost when you have picked up an infection and you could have developed symptoms of vomiting or diarrhoea the water will then be lost from the digestive tract in the form of vomit or faeces. When the fluid turns into an isotonic fluid such as sodium chloride the depletion will have entirely occurred from the extracellular fluid. If the hypertonic fluid is deposited in an extracellular fluid compartment the gap of missing water in the intracellular fluid will be found in the extracellular fluid compartment and the compartment will increase in size due to the extra water. When water is lost from the intra/extracellular fluid compartment certain responses will occur such as vasopressin secretion, stimulation of the renin-angiotensin-aldosterone
The physician suggest to constantly encourage the patient fluids. Since renal dysfunction was diagnosed the physician placed the patient on a renal carbohydrate diet. This is appropriate because the kidneys excrete sodium and potassium. Sodium may need to be restricted and potassium may need to be
A dehydrated brain works harder to accomplish the same amount as a normal brain and it even temporarily shrinks because of its lack of water. Over-hydration, or hyponatremia, is usually caused by over consumption of water in short amount of time. Athletes are often the victims of over-hydration because of complications in regulating water levels in extreme physical conditions. Whereas the dehydrated brain amps up the production of antidiuretic hormone, the over-hydrated brain slows, or even stops, releasing it into the blood. Sodium electrolytes in the body become diluted, causing cells to swell.
These electrolytes are needed to maintain fluid balance in the body. Staying hydrated is one of the ways on how to get rid of