Ch 19 Urinary Output Flashcards
What is the expected pharmalogical action of loop diuretics
They work in the ascending loop of henle
Blocks reabsorption of sodium and chloride to prevent reabsorption of water.
Causes extensive diuresis even with severe renal impairment
What are the therapeutic uses of loop diuretics
They are used when there is need for the rapid administration of fluid
They are used for pulmonary edema caused by HF
They are used in conditions not responsive to other diuretics, such as edema caused by liver, cardiac, or kidney disease or HTN
THESE MEDS MAY ALSO BE USED TO TREAT HYPERCALCEMIA R/T KINDNEY STONE FORMATION
What are adverse effects of loop diuretics
Dehydration Hyponatremia Hypochloremia Hypotension Hypokalemia Decrease in calcium and magnesium levels Ototoxicity ( transient with furosemide and irreversible with Ethacrynic acid)
What are high potassium foods
Bananas, potatoes, Dried fruits, nuts, spinach, citrus fruit
What are signs of hypokalemia
Nausea/ vomiting
General weakness
What is a medication interaction of loop diuretics
Digoxin
Ventricular dysrhythmias can occur in the presence of HYPOKALEMIA
Concurrent use with antihypertensives can cause additive hypotensive effect.
Lithium serum levels can be increased which leads to toxicity
NSAIDS decrease blood flow to kidneys which reduces the diuretic effect
What are signs of low magnesium
Weakness
Muscle twitching
How can a nurse recognize that the loop diuretics worked
Decrease in pulmonary or peripheral edema
Weight loss
Decrease in BP
increase in urinary output
Thiazide diuretics select prototype drug
Hydrochlorothiazide ( Hydrodiuril)
Other drugs; chlorothiazide ( Diuril)
methyclothiazide ( Enduron)
Thiazides type diuretics-
Indapamidem( Lozide, Lozol)
Chlorthalidone ( Hygroton)
Metolazone ( Zaroxolyn)
How do Thorazine diuretics work
They work in the early distal convoluted tubule
Blocks the reabsorption of sodium and chloride, and prevents the reabsorption of water at this site
Promotes diuresis when renal function is not impaired
They are often the 1st med of choice for essential HTN
these meds may be used for edema to mild to moderate HF and liver and kidney disease.
What are adverse effects of thiazides diuretics
Dehydration
Hypokalemia
Hyperglycemia
What are pre assessments of the drug thiazides diuretics
Obtain clients baseline data including Orthostatic BP weight Electrolytes And location and extent of edema
Potassium sparing diuretics
Prototype drug; spironolactone ( Aldactone)
Other drugs; triamterene ( Dyrenium) amiloride ( Midamor)
What is the expected pharmalogical action of potassium sparing diuretics
Blocks the action of aldosterone ( sodium and water rentention) which results in potassium rentention and the excretion of sodium and water
What are the therapeutic uses of potassium sparing diuretics
Oral administration
Used for HF
May take 12-48 hours for effect
What are the side effects of potassium sparing diuretics
Hyperkalemia
Endocrine effects..impotence in men, irregularities in menstrual cycle for woman.
What are med interactions of potassium sparing diuretics
ACE INHIBITORS increase the risk of hyperkalemia
Triamterene may turn the urine what color
A bluish color
What are osmotic diuretics
Osmotic diuretics reduce intracranial pressure and intraocular pressure by raising serum osmolality and drawing fluid back into the vascular and exteavascular space.
What are the therapeutic uses for osmotic diuretics
Prevent kidney failure in specific situations such as hypocovolemic shock and severe hypotension
Decreases intracranial pressure caused by cerebral edema by drawing off fluid from the brain Into the bloodstream
It is administered for oliguria phase of acute kidney failure
What are adverse effects of osmotic diuretics
HF
pulmonary edema
Fluid and electrolyte imbalances
What is an extreme caution of osmotic diuretics
HF
What are med interactions of osmotic diuretics
Lithium excretion through the kidneys is increased
Monitor lithium levels
What are nursing considerations for diuretics
Administer mannitol by continuous IV infusion
High ceiling loop diuretics
Prototype: furosemide (Lasix)
Other drugs: Ethacrynic ( Edecrin)
Bumetanide ( Bumex)
Torsemide ( Demadex)
