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Pharm Exam 3 > CH 24: Diuretic drugs > Flashcards

CH 24: Diuretic drugs Flashcards

1
Q

examines urine for the presence of blood cells, proteins, pH, specific gravity,
ketones, glucose, and microorganisms.

A

urinalysis

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2
Q

primary measures of structural kidney damage.

A

proteinuria and albuminuria

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3
Q

important laboratory tests for detecting
the buildup of nitrogen waste products in the blood.

A

Serum creatinine and blood urea nitrogen (BUN)

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4
Q

The best marker for estimating kidney function

A

glomerular filtration rate (GFR),

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5
Q

volume of filtrate passing through the glomerular capsules per minute. T

A

glomerular filtration rate (GFR),

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6
Q

GFR can be used to predict the:

A

onset and progression of kidney failure and provides an indication of the kidney’s
ability to excrete drugs from the body.

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7
Q

Kidneys are unable to synthesize
enough erythropoietin for red blood
cell production.

A

Anemia

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8
Q

treatment for anemia

A

Epoetin alfa (Epogen, Procrit) or
darbepoetin alfa (Aranesp)

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9
Q

Kidneys are unable to adequately
excrete potassium.

A

hyperkalemia

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10
Q

treatment for hyperkalemia

A

Dietary restriction of potassium;
patiromer (Veltassa) or polystyrene
sulfate (Kayexalate) with sorbitol

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11
Q

Kidneys are unable to adequately
excrete phosphate.

A

Hyperphosphatemia

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12
Q

Hyperphosphatemia treatment

A

Dietary restriction of phosphate

phosphate binders such as calcium
carbonate (Os-Cal 500, others),
calcium acetate (Calphron, PhosLo),
lanthanum carbonate (Fosrenol),
sucroferric oxyhydroxide (Velphoro)
or sevelamer (Renagel)

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13
Q

Kidneys are unable to excrete
sufficient sodium and water, leading
to water retention.

A

Hypervolemia

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14
Q

treatment for hypervolemia

A

Dietary restriction of sodium
loop diuretics in acute conditions
thiazide diuretics in mild conditions

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15
Q

Hyperphosphatemia leads to loss of
calcium.

A

Hypocalcemia

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16
Q

treatment for hypocalcemia

A

Usually corrected by reversing the
hyperphosphatemia, but additional
calcium supplements may be
necessary

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17
Q

Kidneys are unable to adequately
excrete metabolic acids.

A

Metabolic acidosis

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18
Q

treatment for metabolic acidosis

A

Sodium bicarbonate or sodium citrate

19
Q

goal of diuretics

A

trigger the excretion of water and electrolytes from the kidneys, making these drugs a primary
choice in the treatment of renal disease, edema, hypertension, and heart failure.

20
Q

uses of diuretics

A

 HTN
 Heart failure
 AKI and CKD
 Liver failure or cirrhosis
 Pulmonary edema.

21
Q

Inhibits sodium and chloride reabsorption, excretes potassium

A

Loop Diuretics

22
Q

therapeutic uses of loop diuretics

A

Block reabsorption of Na and Cl
in the nephron loop

23
Q

adverse effects of loop diuretics

A

hypokalemia
orthostatic hypotension
tinnitus
nausea
diarrhea
dizziness
fatigue

24
Q

what to monitor for with loop diuretics

A

Monitor BP,
pulse rate,
I and 0
Check potassium
Contain sulfa!
Check for allergies

25
Q

therapeutic effects of furosemide

A

Can cause large amounts of fluid to be excreted from the kidney quickly

Lower bp

26
Q

adverse effects of furosemide

A

Significant hypokalemia
blood dyscrasias
dehydration
ototoxicity
electrolyte imbalances
circulatory collapse

27
Q

what to monitor for with furosemide

A

Monitor potassium
Give IV dose over 1-2 minutes-+
diuresis in 5-10 min
After PO dose diuresis in about 30 min
Weigh the client daily
Don’t give at hs
Encourage potassium-containing foods
Ototoxicity with aminoglycocides
Increase chance of lithium toxicity
Monitor for arrythmias
digoxin toxicity

28
Q

Hydrochlorothiazide: thiazide diuretic
therapeutic effects

A

Interferes with sodium transport
Decrease edema
Prevent renal calculi
Lower bp

29
Q

hydrochlorothiazide adverse effects

A

Hypokalemia
Hyperglycemia
Blurred vision
Loss of Na+
·Dry mouth
Hypotension
Significant hypokalemia
electrolyte depletion
dehydration
hypotension
hyponatremia
hyperglycemia coma
blood dyscrasias

30
Q

monitor for safety with hydrochlorothiazide

A

Monitor electrolytes,
especially potassium
I and 0
Monitor BUN and creatinine
Don’t give at hs
Weigh client daily
Encourage potassium-containing foods
Combined with other antihypertensives
have additive or synergistic effects
with hydrochlorothiazide on blood pressure.
Increased risk with NSAIDS nephrotoxicity
Lithium toxicity possible
Digitoxin additive effect

31
Q

Absorbed in the GI tract
Spare potassium excretion

A

potassium-sparing diuretics

32
Q

adverse effects of potassium sparing diuretics

A

Hyperkalemia
Hyponatremia
Hepatic and renal
damage

33
Q

safety monitoring for potassium sparing diuretics

A

Used with other diuretics
Watch with potassium supplements

34
Q

Spironolactone therapeutic uses

A

Reduce edema
Lower bp

35
Q

adverse effects of spironolactone

A

Tinnitus
Rash
Significant Dysrhythmias (from hyperkalemia)
dehydration
hyponatremia
agranulocytosis
other blood dyscrasias

36
Q

spironolactone safety monitoring

A

Give with meals
Avoid salt substitutes containing potassium
Monitor I and 0
ACE inhibitors increased risk of hyperkalemia
Digoxin toxicity risk
Lithium toxicity risk
ASA can increase levels

37
Q

therapeutic effects of mannitol: osmotic diuretic

A

Inhibits reabsorption of sodium and water
and draws fluid from the intracellular to to vascular
Decrease ICP
Maintain urine flow pt with AKI

38
Q

adverse effects of mannitol

A

thirst and dry mouth

39
Q

safety monitoring of mannitol

A

I and O must be measured
Monitor vital signs
Monitor for electrolyte imbalance
I and O a must!
Very Potent!
Can worsen edema

40
Q

important reminders of implementing diuretics

A

 Teach the patient or caregiver how to monitor pulse and BP. Ensure the proper use and
functioning of any home equipment obtained
 Daily Weights!
 Daily weights should remain at or close to baseline weight. (An increase in weight over 1 kg (2
lb) per day may indicate excessive fluid gain. A decrease of over 1 kg (2 lb) per day may indicate
excessive diuresis and dehydration.)
 Caution with older adult and hypotension!
 Rise slowly
 Do not take if BP below 90/60
 Need regular labwork!
 Report tinnitus
 Encourage fluids unless contraindicated

41
Q

educate diuretic pts on SS of:

A

o hypokalemia
o hyperkalemia
o digoxin toxicity
o hyperglycemia
o gout

42
Q

take diuretics early in the day to avoid:

A

nocturia

43
Q

most frequent cause of AKI

A

hypoperfusion

Pharm Exam 3 (5 decks)

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