Question 1

if a pt has chf, hypotension & is dehydrated,  could it matter if the iv fluid is normal saline if the pt also has hypernatremia?

Accepted Answer

Normal Saline: if the patient is hypernatremic, normal saline will bring the patient's sodium level closer to normal, while treating their dehydration. It is a delicate balance to try and resuscitate a hypotensive heart failure patient, and manage their fluid balance. I hope it turns out for the best. I'm sure the team is watching the sodium levels carefully and adjusting as needed.

Question 2

if an elderly person has renal impairment, chf & hypernatremia (sodium presently 157 mmol/l) would it seem to be appropriate for him to be on a normal saline iv fluid? other conditions are copd, pleural effusion, t2 diabetes, delirium, mild hepatic dysfun

Accepted Answer

May be not !!!!: Fluid management in a complex patient is a very complex issue and a strait forward yes or no is not the answer. Amount of fluid administered along with medications being given make it further complex. There is no harm bringing up this question with patient's current physicians.

Question 3

what could you give to a patient with chf?

Accepted Answer

Heart Failure: There are 2 types of heart failure. Diastolic and Systolic heart failure.  One is failure to contract while other is failure to relax. Equal prognosis

What can you do?
- Lifestyle Modifications are key
- healthy Diet, no smoking, low sodium are very important

Medications usually given
- Beta Blockers, ACEinhibitor/ARBs, Aldosterone blockers, Nitrates/Hydralazine (better in Black Males)

Question 4

wanted to know if chf patients in general receive fluids while in the icu?

Accepted Answer

Yes, but not much: Most CHF patient are treated with diuretics, to remove fluid from circulation. In some instances, depending on the cause of CHF, we might give a modest amount of fluid to keep the heart filled properly so it can pump.

Question 5

can you give beta blockers to a chf patient?

Accepted Answer

Yes: Long time ago the first beta blockers  like propanolol were contraindicated in chf. Nowadays we prefer to use more selective beta blockers for CHF like coreg(r)(carvedilol) or metoprolol.Poole-wilson pa, swedberg k, cleland jg, et al. Comparison of Carvedilol and metoprolol on clinical outcomes in patients with chronic heart failure in the Carvedilol or metoprolol european trial (comet): randomise.

Question 6

how to reduce or eliminate fluid retention for chf patients?

Accepted Answer

Restrict salt: Salt intake causes fluid retention. Heart failure patients need to monitor the amount of salt in the foods they consume. The salt intake should be no more than 2-4 grams daily, less if someone has severe failure. Fluid intake also needs to be restricted to 1.5 liters per day or less, depending on the doctor's recommendation.

Question 7

if a patient has copd and chf can you give them albuterol?

Accepted Answer

CHF: A patient with COPD and CHF can generally use albuterol. Some patients with CHF have signficant arrhythmias and for these there is some danger of triggering a serious arrhythmia. This discussion should be had with the patient's dr.

Question 8

my mom just called me from hosp and said she is on magnesium. why would they give a patient with copd, chf and diabetic magnesium? maybe she's confused

Accepted Answer

It is very good: For both COPD and chf


she should  continue at home if her doc agrees.

Question 9

is it dangerous to wear compression stockings if a chf, patient has some edema, fluid on  lungs, and disolving blood clots in the lungs?

Accepted Answer

Stockings: The situations you have listed are the very situations for which stockings are recommended.

Question 10

should a patient who has veinous ulcers developing under the skin wear decompression stockings? patient has fluid on lungs; some edema; chf. ?

Accepted Answer

Venous ulcers: Venous stasis ulcers are exacerbated by swelling of the ankles. Compression stockings that help to keep the swelling down are beneficial.  If actual ulcers are present treatment of the ulcers will also be required and you should see your doctor for that.

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Doctor answers about:

Why should i not give chf patient too much iv fluid

A member asked:

If a pt has chf, hypotension & is dehydrated, could it matter if the iv fluid is normal saline if the pt also has hypernatremia?

A member asked:

If an elderly person has renal impairment, chf & hypernatremia (sodium presently 157 mmol/l) would it seem to be appropriate for him to be on a normal saline iv fluid? other conditions are copd, pleural effusion, t2 diabetes, delirium, mild hepatic dysfun

A member asked:

What could you give to a patient with chf?

A member asked:

Wanted to know if chf patients in general receive fluids while in the icu?

A member asked:

Can you give beta blockers to a chf patient?

A member asked:

How to reduce or eliminate fluid retention for chf patients?

A member asked:

If a patient has copd and chf can you give them albuterol?

A member asked:

My mom just called me from hosp and said she is on magnesium. why would they give a patient with copd, chf and diabetic magnesium? maybe she's confused

A member asked:

Is it dangerous to wear compression stockings if a chf, patient has some edema, fluid on lungs, and disolving blood clots in the lungs?

A member asked:

Should a patient who has veinous ulcers developing under the skin wear decompression stockings? patient has fluid on lungs; some edema; chf. ?

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