Urinary Fluid Electrolytes Essay -- Health, Hearth Disease

A 60 years old man was admitted into the hospital with congestive heart failure and a history of heart disease. Heart failure lead to this patients potentially fatal diagnosis of pulmonary and peripheral edema. The heart actively works as a double pump meaning that each side could independently fail. When the heart starts to fail, a reduced renal perfusion and sympathetic activation to the kidneys stimulate the release of renin. Renin will cleave on to angiotensinogen to create angiotensin I. Angiotensin I then travels through the lungs where the enzyme ACE cleaves off two amino acids to form angiotensin II. Angiotensin II stimulates the release of the hormone aldosterone will increase the renal reabsorption of sodium and water. The increased volume can be deleterious leading to pulmonary and peripheral edema (Klabunde, PhD. 2007). When the left side of the heart fails pulmonary edema occurs. As the heart fails, the blood vessels become engorged with blood and pressure increases in the lung capillaries pushing fluid into the alveoli and lung tissue. As a result oxygen is unable to move as it typically would, causing a shortness in breath (Heller MD, 2009). If this was left untreated the patient may suffocate. The patient is also suffering from peripheral edema this is usually due to the right side of the heart failing. Once the right side of the heart fails, it can no longer effectively pump oxygenated blood through the capillaries. Blood then begins to stagnate in the bodies organs and fluid gets pushed into interstitial tissue (Marieb, 2010). Swelling generally occurs in the lower extremities and can cause permanent nerve damage if untreated. The patient was administered a potent loop diuretic to treat his edema, furosemide... ...opment of hepatic encephalopathy to worsen (Seifter, 2007). Hyperaldosteronism has also been associated with hypokalemia leading to renal cystic disease. Cysts begin to appear in the collecting duct epithelium leading to interstitial fibrosis. The cause of these cysts are unknown however ammoniagenesis seems play a role (Seifter, 2007). Furthermore, increased urination or polyuria is another complication. Increased thirst from the increase of angiotensin II also acts on the thirst center in the hypothalamus (Crumley, 2009). This is a mild form of diabetes insipidus. In conclusion, loop diuretics should be used with extreme caution when treating patients with congestive heart failure. Electrolytes test should be run frequently while on this medication. If this patient wouldn’t have come in his conditions could have worsened resulting in a life threatening situation.