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Nanju > Ch 27 Urinary Output > Flashcards

Ch 27 Urinary Output Flashcards

0
Q

What is a creatinine lab

A

Diagnostic test that truly tells how well the kidney are functioning

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1
Q

How much urine does the kidney need to produce before they start to shut down

A

At least 30 ml hour

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2
Q

What is osmolality

A

The strength or concentration of the urine produced

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3
Q

What does the renal system consist of

A

Kidneys

Ureter and bladder

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4
Q

What is one reason for kidney failure

A

Long standing diabetes

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5
Q

What drugs are used in treating fluid overload or edema

A

Diuretics

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6
Q

What conditions does diuretics treat

A 
Chronic heart failure
Pulmonary edema
HTN
Cirrhosis ( liver failure)
Nephrotic syndrome
Kidney failure
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7
Q

What is the prototype drug of thiazide diuretics

A

Hydorchlorothiazide ( HydroDIURIL)

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8
Q

What are thiazide diuretics used for

A

In the treatment of hypertension

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9
Q

Where does thiazide diuretics work

A

In the distal tubule

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10
Q

What are contraindications and precautions of thiazide diuretics

A

Severe renal impairment
Anuria
Hepatic coma
Hypersensitivity

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11
Q

What are adverse effects of thiazide diuretics

A 
Hypokalemia 
Hyponatremia 
Hypochloremia
Hypomagnesemia
HYPERCALCEMIA
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12
Q

What drug does thiazide diuretics interact with

A

Digoxin

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13
Q

With any diuretic what should you monitor for

A

Hypokalemia

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14
Q

What is a contraindication to thiazide diuretics

A

Sulfa

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15
Q

What are signs and symptoms of hypokalemia

A

Arrhythmias

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16
Q

What is a sign of hyponatremia

A

The body craving salt

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17
Q

Hydrochlorothiazide is more effect in what ethnic group

A

African Americans

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18
Q

What is a loop diuretic

A

They excerpt a powerful effect on fluid and electrolyte balance
They work in the loop of henle to inhibit sodium and chloride

19
Q

What are loop diuretic used for

A

Pulmonary edema
CHF
Peripheral edema
it depletes K+ very fast

20
Q

What is the prototype drug of loop diuretics

A

Furosemide ( lasix)

21
Q

How are loop diuretics administered

A

IV or oral

Excreted in the kidneys

22
Q

What are adverse effects of loop diuretics

A

Electrolyte imbalance
Ototoxicity if pushed too fast
Alteration in blood glucose levels
Alecia man

23
Q

What 2 drugs shouldn’t be given concurrently with loop diuretics

A

Digoxin

Aminoglycosides

24
Q

How long should one push furosemide

A

20-40 mg over 1-2 minutes

Closely monitor potassium levels

25
Q

What labs should be monitored with furosemide

A

CBC
SERUM ELECTROLYTE
URIC ACID LEVELS

26
Q

Wh would a pt who is malnourished be at greater risk for toxicity from furosemide

A

Because the malnourished pt has less protein in the body which will result in more free drug. Furosemide is a highly protein bound drug

27
Q

Potassium sparing diuretics prototype drug

A

Triamterene ( Dyremium)

28
Q

What are potassium sparing diuretics used for

A

It is used as an adjunct to manage edema and HTN

29
Q

What is indomethacin used for

A

It is an anti inflammatory that treats gout

30
Q

What are adverse effects of triamterene ( Dyrenium)

Potassium sparing diuretic

A 
Hyperkalemia
Nephrotoxic it's
Thrombocytopenia 
Elevated liver enzymes
Headache
Photosensitivity
31
Q

What lab level indicates thrombocytopenia

A

Platelet count less than 50,000

32
Q

What are normal platelet counts

A

150,000-450,000

33
Q

What are osmotic diuretics used for

A

They are used for intracranial pressure
& pushes fluid back into vascular space
Cerebral edema
And reduces intraocular pressure

It causes a severe electrolyte imbalance it is a very strong diuretic

34
Q

What is the only way that mannitol is administered

A

IV

35
Q

What is a test to determine how well the renal system is functioning

A

GFR

36
Q

The bigger the dilation of a persons pupils are a indicator of what

A

You are going to die!

Coma is occurring

37
Q

What are contraindications and precautions of mAnnitol (osmotic diuretic)

A

Severe renal disease
Pulmonary congestion
Active intracranial bleeding

38
Q

What are adverse effects of osmotic diuretics ( mannitol)

A

Fluid or electrolyte imbalances
Hypotension
Tachycardia

39
Q

What are major drug interactions of mannitol ( osmotic diuretic)

A

NONE

40
Q

How can one maximize the therapeutic effects of mannitol

A

Know than concentrations that exceed 15% have a tendency to crystallize.
An inline filter should be used for the infusion

41
Q

How can one minimize the adverse effects of mannitol( osmotic diuretic)

A 
Monitor hourly output 30-50 ml/ hr at least
Monitor BP
pulse rate
Electrocardiographic tracings
Intake to output ratios
Renal function test results
Serum electrolyte levels
42
Q

How should mannitol be administered

A

Parenterally

.2g over 3-5 min in 2 doses

43
Q

What is mannitol administered for

A

Cerebral edema

Increase intraocular pressure

44
Q

Sodium bicarbonate

A

ABGs

Base

Nanju (15 decks)

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