Congestive Heart Failure (CHF).
A 41-year-old obese male patient is diagnosed with congestive heart failure (CHF). He is told to begin a moderate exercise routine with a healthy diet and is prescribed several medications — including a diuretic.
Based on your knowledge of the kidney and the disease of CHF, what factors would be important in selecting a specific diuretic? How would you explain to this patient how it works?
If this patient developed a disease that caused the renal blood flow to be diminished, how might this impact the medication he is taking for his congestive heart failure? As his health care provider, how would you change his treatment in this situation?
Sample Answer
Factors to consider when selecting a diuretic for congestive heart failure (CHF)
The following factors are important to consider when selecting a diuretic for a patient with CHF:
- Severity of CHF: More severe cases of CHF may require more potent diuretics.
- Comorbidities: The patient’s other medical conditions must also be considered, as some diuretics may interact with other medications or worsen other conditions. For example, a patient with diabetes may need a diuretic that is less likely to cause hypoglycemia.
- Renal function: The patient’s renal function must also be considered, as some diuretics can worsen kidney function.