Fluid & Hormones | Regulation of Fluids (RAAS, ADH, & BNP)

[Music] let's talk about the hormones that keep fluids inside the body and not in the potty now I call these are nasty hormones because they cause huge problems for a heart failure patient they basically fill our bodies up with fluid now this leads to high blood pressure fluids in the lungs which sounds like crackles massive weight gain and Bloated skin that looks like memory foam mattresses something called edema so now let's get into our lineup here now first on the list it's the famous elderone hormone AKA OST tyone now he's the bouncer at the nightclub Club Raz that holds Miss sodium inside the body and retains fluid next we have our renin Angiotensin aldosterone system this is what's called nightclub Raz as mentioned before this place gets super lit it basically holds all the fluid inside the body and leads to nasty alems with our heart failure patients which we'll get into in a moment next is our ADH our anti diuretic hormone which I call adaga it's basically a revolving door or a water mill that keeps water inside the body and not in the potty next is our A&P our atrial nutritic peptides which released by The atriums are kind of like the special forces or Navy Seals if you will they're specially contracted to kill aldosterone hormone in the kidneys to help it let go of sodium and water out of the body and lastly we have BNP brain nut rtic peptides which are released by the ventricles in the heart not to be confused with BMP basic metabolic panel BNP is just a speedometer that tells how bad your heart's doing it simply measures all the pressure that's put on those ventricles for heart failure all right guys let's get into their functions here so for elderone is a steroid hormone blocked by the diuretic spon a lactone now aldosterone aldosterone I call osty rone he's a steroid hormone or basically the bouncer to the nightclub Raz renin Angiotensin elderone system his main job is to keep water inside the body and not in the potty but basically to keep blood pressure up in the body now he does this by blocking Miss salty sodium at the kidney doors and prevents her from leaving now as long as Miss sodium is prevented from leaving then her water Paparazzi which follows her around stays inside the body too because please remember where sodium goes well water flows now when this Raz system M functions with our heart failure patient It ultimately leads to Major fluid volume overload problems so let's get into exactly what the renin Angiotensin aldosterone system is who Mr renan is and who exactly are these Angiotensin one and Angiotensin 2 Sisters so let's get all the juicy details in our club Raz wrapup right now I got some very exciting news for you guys today today we're going to a very hot nightclub the most exclusive and exciting dance party of the body so go get your hair done get them nails did and call up your friends cuz we getting turned up in this mug you know what I'm saying we're talking all about Club Raz the renin Angiotensin aldosterone system right now we're going to cover all the pathophysiology and finally understand all that difficult pharmacology like ACE inhibitors arbs and spironolactone oh my gosh I'm so excited so let's get into this right [Music] now all right that was pretty weird now let's get into this lecture here well every nightclub has doors correct well the same thing as your body your body has two main doors serving as exit for fluids and waste this is known as your kidneys I mean how else would you get fluid out of the body and into the potty I mean technically you can sweat it out or you can vomited out but really the best way is to excrete all that fluid from your kidneys so your kidneys are like doors to Our Night Club Raz and this club Raz let's fluid out of the body and into the body so let's introduce our three main characters to our nightclub management system first on the list is elderone hormone which I call OST tyone the bouncer security guard now he's a steroid hormone that holds the kidney do shut and makes sure no fluid is coming out because like come on we all know that a packed Club is a hot popping Club you know what I'm saying so tyone holds onto sodium in the kidneys in order to retain water in the body so guys write that down that's probably going to be on your test next we have Mr renan the CEO because every nightclub has upper management right he's the shot caller overseeing everything and this upper management is located right at the top of the kidneys in the adrenals which makes sense because they're on top they're upper management right now the president Mr renan is the boss he calls all the shots he's like the mobster sh he does what he wants sh his number one goal is to pack out that club with water because he wants to boost revenue and keep that club packed and popping so he uses a little telephone system to communicate to alone to shut down the kidneys and hold on to our famous celebrity Miss salty sodium so that we can retain fluids and boost blood pressure but how exactly does he do this well he uses Angiotensin 1 and Angiotensin 2 the secretaries AKA Angie 1 and Angie 2 now these two gals relay messages for Mr renin all the way from the top of the kidneys to the bottom of the kidneys where aldosterone is so when aldosterone finally gets the message he makes sure to hold on to sodium and also hold on to water before they leave the club now a little side note since Miss salty sodium is super famous and such a big deal the water Paparazzi stay around as well now once again to reiterate it again this ultimately keeps water inside the body keeps the blood pressure up and makes sure our patient doesn't diares or pee but again too much can cause high blood pressure or hypertension now this puts huge pressure on our heart and blood vessels shown as bounding pulses jvd in the neck veins leading to serious conditions like CAD or ACS or even a heart attack known as an MI now listen elderone is doing a great job at his duties but he's honestly doing too much of a good job and you know how homeostasis is too much of one thing is not a good thing so long story short aldosterone has to be stopped he's increasing the blood pressure way too much so how can we prevent all this pressure and all this builtup of fluids basically the club of your body is now at capacity and it's a huge huge Hazard so what can we do in the medical field to stop this elderone hormone well it's simple really we'll just cut the communication lines from the head at the top Mr renan all the way down to aldosterone at the bottom now this cutting of communication lines that's what's known as an Ace inhibitor drugs that end in pill now ACE inhibitors are Angiotensin converting enzyme Inhibitors which simply cut communication lines between the secretaries ang1 and Ang 2 it stops Angiotensin 1 from converting into Angiotensin 2 so without the secretaries communicating to each other ostero never gets the message to keep sodium and water inside the body so miss salty sodium and her water papari exit the body and into the potty resulting in decreased blood pressure taking pressure off the heart which is also called decreasing the workload of the heart now as for arbs or drugs that end in stin known as our Angiotensin receptor blockers essentially put ear muffs on angie2 so if Angie 1 and Angie 2 can't communicate to each other they can't relay any messages together so the same outcome happens here with aldosterone he doesn't get the message and he doesn't hold on to the water so once again miss salty sodium and her water Paparazzi exit the body and into the body this decreases our blood pressure takes pressure off the heart which again we call this decreasing the work workload of the hearts lastly if all else fails we use our very last option spironolactone it's the super expensive potassium sparing diuretic often used as a lastline therapy meaning it's used after ACE inhibitors or arbs don't work now spironolactone is a Hitman he's a mercenary he takes out aldosterone directly it's like a pretty harsh drug man now it doesn't mess around with the Angie secretaries it just goes straight for Tyrone himself and since the diuretics are especially engineered to be potassium sparing well then it keeps potassium inside the body so you must educate your patients to keep the same dietary intake of potassium don't increase and don't decrease so those green leafy vegetables those fruits and veggies those bananas and avocados you guys make sure to keep that at an even pace so use my Nifty acronym bgf bananas green leafy veggies and fruits all have high potassium also no salt substitutes these contain potassium too so educate your patients not to increase their pottassium intake now this is huge not to increase or decrease just keep it at an even level now the cool thing about this drug is the suffix or the ending of the drug is easy to remember because spironolactone sounds just like elderone right tone tone so it's kind of easy to remember that this drug blocks aldosterone directly yeah is this a drug neighbor's Inc yes yes I just wanted to thank you guys for finally making a drug that sounds like its action oh my gosh now I'll be calling you back when you can do the same for antibiotics jeez goodbye so hopefully that makes a little more sense with our ACE inhibitors and arbs and spona lactone those potassium sparing diuretics because once you block the lines of communication and Tyrone or aldosterone is taken out of the picture then miss salty sodium leaves and all that excess fluid flows out of the body and into the potty ultimately decreasing that workload of the heart which ultimately with our head to toe assessments we'll see it as a decrease in bounding pulses decrease in jbd that jugular vein distension a decrease in edema or that water bed skin as well as a decrease in blood pressure so watch out for fainting when standing up too quickly something called orthostatics okay now for some quick side effects about ACE inhibitors and arbs we use our Nifty acronym Cal so watch out for cough angioedema and low blood pressure now a cough is usually from the scratchy prostate glanding that are produced by this drug now angio edema is a red swollen tongue and swollen lips and low blood pressure is usually in the form of orthostatic hypotension so a big big fall precaution and finally spironolactone or potassium sparing diuretics the biggest nursing consideration is hyperkalemia too much potassium so educate your patients on bgf dietary Habits Stay away from bananas green leafy veggies and fruits again no salty substitutes these contain potassium too so teach your patients not to increase their potassium and not to decrease just keep it at a nice even Rhythm all right guys that wraps it up for this we're going to go into ADH right now now next is ADH our anti-diuretic hormone which I call add the H2O or basically add the water because it adds water to your body it keeps water from exiting the kidneys by reabsorbing it so when water is added to the body it's add the H2O for ADH add the water lastly is nutritic peptides now what the heck are nutritic peptides well the medical definition are hormones secreted by cells that lie in the heart chambers when there is damage presented there's simply a good way to determine if the chambers in your heart are being stretched out too much from a buildup of blood pressure in the heart now we have two types of nutritic peptides the first type is& atrial nutritic peptides in the atriums the upstairs of the heart next is the BNP the brain nutritic peptides in the ventricles the downstairs of the heart it's kind of like a speedometer hormone to show us how bad the damage in the heart actually is so more hormone that is present the more damage in those ventricles now let's dive a little deeper into our brain nutritic peptides which is vital lab for a heart failure patients now I want you guys to think very very simply here if the heart has to work harder than usual over a long period of time from all that high blood pressure being pushed on it maybe from a super high sodium diet maybe from a seditary couch potato lifestyle or even high cholesterol foods or even renal failure holding all that fluid inside the body ultimately BNP is the biggest indicator for heart failure the heart releases more BNP to the measure and degree of the wear and tear or the deterioration of the ventricles mainly the big mama ventricle on the left now atrial nutritic peptides are very different than B&P they're not necessarily a marker that measures the wear and tear on the heart A&P are kind of like a special forces that tries to assassinate OST Tyrone in the kidneys because OST Tyrone is the bouncer or security guard in the kidneys that hold sodium and fluid in the body so& is secreted as kind of a defense system in response to increasing blood pressure and increasing blood volume which stretches out and damages the heart tissue the atrial nutritic peptides act like the Special Forces because they go down into the nefron into the functioning unit of the kidney and they create an opposite effect of aldosterone so now in the kidney the reabsorption of sodium is blocked and at the same time the filtration rate of the kidney is increased so what happens is we have a release of fluid from the body and into the potty all fancy words for& done killed aldosterone so all that water flows out of the body and into the potty now it's technically kind of bad when A&P levels do increase because this indicates a war is going on and this happens with acute heart failure or SVT super ventricular tacac cardia even hyper thyroidism and even in small cell lung cancers but interestingly enough levels actually decrease with chronic heart failure and critically think this for a second it's because &p gets worn out over a long period of time it gives up in the battle basically the body can't do everything to combat this high blood pressure so that's when our patients get put on drugs like ACE inhibitors arbs or potassium sparing diuretics in order to finish the job your body was unable to do so in closing please understand that even before we give your patients any type of medication your body already has tried numerous backup plans to try and fix the problem this is what we called a self-regulation process thanks for watching for our full video and new quiz Bank click right up here to access your free trial and please consider subscribing to our YouTube channel last but not least a big thanks to our team of experts helping us make these great videos all right guys see you next time [Music]

Channel: Simple Nursing

Views: 99,677

Keywords: Fluid and electrolytes for nursing students, electrolytes, electrolyte imbalances, Renin angiotensin aldosterone system, antidiuretic hormone, diuretic, edema, aldosterone hormone, hormones, angie 1, angie 2, atrial natriuretic peptides, ANP, BNP, brain natriuretic peptides, B type, proB-type, blood pressure regulation, Registered nurse RN, RN, Osmosis, Pharmacology, NCLEX, ATI exit, HESI exit, Kaplan, student nurse, nursing student, simplenursing, simple nursing

Id: xOa0n4nTLT8

Length: 15min 56sec (956 seconds)

Published: Wed Aug 21 2019