ATI section 8: Medications Affecting the Urinary System Flashcards

1
Q

Diuretics

A
  • Action: increase the amount of fluid excretion via the renal system
  • Loop: Furosemide, Bumetanide
  • Thiazide: Hydrochlorothiazide, Chlorothiazide
  • Potassium Sparing: Spironolactone, Triamterene
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2
Q

Diuretics

Therapeutic use

A
  • Pulmonary edema caused by heart failure

- Edema unresponsive to other diuretics

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3
Q

Diuretics

Precautions/Interactions

A
  • Use cautiously in clients who have DM
  • Contraindicated during pregnancy
  • NSAIDs reduce diuretic effect
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4
Q

Diuretics

Side/Adverse Effects

A
-Loop and thiazide diuretics:
Hypovolemia
Ototoxicity
Hypokalemia
Hyponatremia
Hyperglycemia
Digoxin toxicity
Lithium toxicity

-Potassium-sparing diuretics
Hyperkalemia
Endocrine effects (impotence, menstrual irregularities

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5
Q

Osmotic Diuretics

A

-Mannitol

-Therapeutic Use
Prevent renal failure related to hypovolemia
Decrease intracranial pressure related to cerebral edema
Decrease intraocular pressure

-Precautions/Interactions
Use with caution in heart failure
May increase digoxin levels due to hypokalemia

-Side/Adverse Effects
Pulmonary edema
F&E imbalances
Thirst, dry mouth

-Nursing Interventions and Client Education
Monitor daily weight, I&O, and electrolytes
Monitor for signs of hypovolemia
Monitor neurological status

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6
Q

Osmotic Diuretics

A

-Mannitol

-Therapeutic Use
Prevent renal failure related to hypovolemia
Decrease intracranial pressure related to cerebral edema
Decrease intraocular pressure

-Precautions/Interactions
Use with caution in heart failure
May increase digoxin levels due to hypokalemia

-Side/Adverse Effects
Pulmonary edema
F&E imbalances
Thirst, dry mouth

-Nursing Interventions and Client Education
Monitor daily weight, I&O, and electrolytes
Monitor for signs of hypovolemia
Monitor neurological status

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7
Q

Diuretics

Therapeutic use

A
  • Pulmonary edema caused by heart failure

- Edema unresponsive to other diuretics

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8
Q

Diuretics

Precautions/Interactions

A
  • Use cautiously in clients who have DM
  • Contraindicated during pregnancy
  • NSAIDs reduce diuretic effect
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9
Q

Sexual Dysfunction

A

-Sildenafil (Viagra), Tadalfil (Cialis), Vardenafil (Levitra)

-Therapeutic Use
Erectile dysfunction
Sexual dysfunction in women (unlabeled use)

-Precautions/Interactions
Contraindicated for clients taking nitrate drugs, anticoagulants, alpha blockers for BPH, or antihypertensives
Contraindicated for clients who have a hx of stroke, uncontrolled DM, hypo/hypertension, or heart failure

-Side/Adverse Effects
headache, heartburn, diarrhea, flushing, nosebleeds, difficulty falling asleep, paresthesias, muscle aches, changes in color vision, sensitivity to light

Nursing Interventions and Client Education

  • Administer 1 hr before sexual activity, do not use more than once daily
  • Instruct avoid intake of any organic nitrates
  • Instruct client to stop taking medication and notify prescriber immediately for any of the following: erection lasting longer than 4 hr, any loss of vision, and unusual bleeding problems
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10
Q

Diuretics

Nursing Interventions and Client Education

A
  • Monitor I&O
  • Monitor vital signs
  • Monitor F&E imbalances
  • Administer early morning to prevent nocturia
  • Instruct clients taking loop/thiazide diuretics to increase intake of foods high in potassium
  • Instruct clients taking potassium-sparing diuretics to avoid salt substitutes
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11
Q

Osmotic Diuretics

A

-Mannitol

-Therapeutic Use
Prevent renal failure related to hypovolemia
Decrease intracranial pressure related to cerebral edema
Decrease intraocular pressure

-Precautions/Interactions
Use with caution in heart failure
May increase digoxin levels due to hypokalemia

-Side/Adverse Effects
Pulmonary edema
F&E imbalances
Thirst, dry mouth

-Nursing Interventions and Client Education
Monitor daily weight, I&O, and electrolytes
Monitor for signs of hypovolemia
Monitor neurological status

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12
Q

Alpha-Adrenergic Blockers for Urinary Hesitancy

Tamsulosin

A

-Inhibits smooth muscle contraction in the prostate, which improves the rate of urine flow for clients with BPH

-Precautions/Interactions
Must rule out bladder cancer prior to administering
Combined use with cimetidine may facilitate toxicity

-Side/Adverse Effects
May cause decreased libido, reduce ejaculate

-Nursing Interventions and Client Education
Take 30 min after meat at same time each day
Teach client to contact prescriber if greater than 4 doses are missed

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13
Q

Alpha-Adrenergic Blockers for Urinary Hesitancy

Bethanechol

A

-Increases detrusor muscle tone to allow strong start to voiding for clients with postoperative urinary hesitancy

-Precautions/Interactions
Do not administer IV or IM
Contraindicated for clients with hypotension or decreased cardiac output

-Side/Adverse Effects
Excessive salivation, tearing

-Nursing Interventions and Client Education
Administer on empty stomach

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14
Q

Anticholinergic Medications for Overactive Bladder

A
  • fenacin, dine, Oxybutynin, Trospium

-Therapeutic Use
Urinary incontinence
Urinary urgency and frequency

-Precautions/Interactions
Do not use for clients who have intestinal obstruction
Use with other anticholinergics can increase anticholinergic effects

-Side/Adverse Effects
Anticholinergic symptoms
Drowsiness
Dyspepsia

-Nursing Interventions and Client Education
Administer medication with a full glass of water
Instruct client that full effects may take 1-2 months
Instruct client to manage anticholinergic side effects
instruct client to report constipation lasting longer than 3 days

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15
Q

Sexual Dysfunction

A
  • Sildenafil (Viagra), Tadalfil (Cialis), Vardenafil (Levitra)
  • Therapeutic Use
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