Show
 AbstractPatients with heart failure (HF) are at risk of developing hyponatremia due to retention of fluids which dilutes serum sodium. Studies have demonstrated that health care professionals have inadequate knowledge of managing hyponatremia in patients with HF. We created a mnemonic that provides nurse practitioners with an evidence-based approach to managing hyponatremia in HF. The “FIRST” mnemonic features 5 different treatment options: Fluid restriction, Induced diuresis, Received no specific treatment for hyponatremia, Saline (isotonic and hypertonic), and Tolvaptan. Section snippetsPathophysiology of Hyponatremia in Heart FailureHeart failure (HF) is a clinical diagnosis characterized by insufficient cardiac output producing functional limitations, fluid overload, and an inability to meet the metabolic needs of the body.1 As a result of severe fluid retention, dilutional hyponatremia is a common and severe concern for the patient with HF.2 Hyponatremia develops in approximately 10% to 30% of hospitalized patients with HF.3 A systematic review and meta-analysis by Corona et al4 established that hyponatremia was BackgroundA cohort study conducted by Miller et al15 explored the knowledge and understanding of Canadian health care professionals regarding management of hyponatremia in patients with HF. Miller et al15 established that only 69% of study participants identified the proper pathophysiology, 44% managed hyponatremia inadequately, and 61% of the participants selected the wrong sodium correction rate. The results of this study confirm the presence of a knowledge gap; thus, health care professionals, such as F—Fluid RestrictionThe Canadian Cardiovascular Society guidelines recommend a fluid restriction of 2 L/d for patients with HF who struggle with congestive symptoms.18 However, for patients with HF with hyponatremia, the Canadian Cardiovascular Society recommends a fluid restriction of ≤ 1.5 L/d.18 In addition, the American Heart Association established that fluid restriction is an appropriate and beneficial intervention for hyponatremia in heart failure.19 Many scholars state that a rapid increase in weight of 2 ConclusionThe mnemonic presented is a helpful tool for clinicians to recall and apply guideline-driven medical interventions to manage patient with hyponatremia in the context of HF. Early identification of hyponatremia and appropriate choice of treatment by the NP will result in favorable patient outcomes and decreased hospital length of stay. We provided a scientific comparison of the treatment options, including their benefits and drawbacks. The FIRST acronym organizes thought and provides NPs with a Mohamed Toufic El Hussein, PhD, NP, is an associate professor, School of Nursing and Midwifery, Mount Royal University, Calgary; an adjunct associate professor, Faculty of Nursing, University of Calgary; and NP in the Cardiology Critical Care Unit at Alberta Health Services Rockyview Hospital, Calgary, Alberta, Canada, and can be contacted at [email protected].
References (34)
The Canadian Cardiovascular Society heart failure companion: bridging guidelines to your practiceCan J Cardiol(2016) Hyponatremia in heart failure: pathogenesis and managementCurr Cardiol Rev(2019) The economic burden of hyponatremia: systematic review and meta-analysisAm J Med(2016) Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendationsAm J Med(2013) Hyponatremia and hypernatremia: a practical guide to disorders of water balanceArch Intern Med Res(2020) Hyponatremia-presentations and managementClin Med (Lond)(2017) Hyponatremia: a reviewJ Intensive Care Med(2016) Cited by (0)Recommended articles (6)Mohamed Toufic El Hussein, PhD, NP, is an associate professor, School of Nursing and Midwifery, Mount Royal University, Calgary; an adjunct associate professor, Faculty of Nursing, University of Calgary; and NP in the Cardiology Critical Care Unit at Alberta Health Services Rockyview Hospital, Calgary, Alberta, Canada, and can be contacted at [email protected]. Shani Markus and Sara Piedrahita are students in the BN program at Mount Royal University, Calgary, Alberta, Canada. View full text© 2020 Elsevier Inc. All rights reserved. Which medication would the nurse administer to counter the signs of toxicity when infusing magnesium sulphate IV to a patient with preeclampsia?Calcium gluconate: the antidote for magnesium toxicity is calcium gluconate 1 g IV over 3 minutes. Repeat doses may be necessary. Calcium chloride can also be used in lieu of calcium gluconate. The suggested dose for calcium chloride for magnesium toxicity is 500 mg of 10% calcium chloride IV given over 5-10 minutes.
Which nursing intervention is most appropriate when caring for a client with dehydration?Administer intravenous hydration if needed.
Severely dehydrated patients or patients unable to take oral hydration may require IV hydration to maintain appropriate hydration level.
Which is a priority nursing action when providing care to a patient who is being treated for Hypernatremia that developed slowly over several days?The answer is D: Give slowly and watch for signs and symptoms of cerebral edema. The most important intervention is to give slowly and watch for S&S of cerebral edema because a hypotonic solution can cause rapid swelling of the cell. Maintain a patent IV is correct but not the most important option in this scenario.
Which action will the nurse perform to ensure the patient safety when preparing to administer IV potassium chloride to a patient?Hands down, this is the most effective safeguard to prevent inadvertent IV administration of undiluted potassium chloride.
|
Which medication would the nurse associate to the treatment of a patient with hyponatremia secondary to heart failure?
zusammenhängende Posts
Urheberrechte © © 2024 nguoilontuoi Inc.
