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NURS 306 > Chapter 28: Diuretic Drugs > Flashcards

Chapter 28: Diuretic Drugs Flashcards

1
Q

What are the 3 types of diuretic drugs?

A
  1. loop diuretics
  2. potassium-sparing diuretics
  3. thiazide and thiazide-like diuretics
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2
Q

Diuretics

A

drugs that accelerate the rate of urine formation via a variety of mechanisms.

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3
Q

Result of diuretics is

A

the removal of sodium and water from the body

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4
Q

Loop Diuretics include

A

furosemide, bumetanide, torsemide

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5
Q

Mechanism of Action: Loop Diuretics

A

blocks sodium reabsorption in the thick ascending loop of Henle

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6
Q

Loop Diuretics: Drug Effects

A
  • Potent diuresis and subsequent loss of fluid
  • Decreased fluid volume
  • Potassium and sodium depletion
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7
Q

Loop Diuretics: Indications

A
  • Edema associated with HF or hepatic or renal disease
  • Hypertension
  • Hypercalcemia (calcium excretion by kidneys)
  • Congestive Heart Failure (from diastolic dysfunction)
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8
Q

Loop Diuretics: Adverse Affects to the CNS

A
  • blurred vision
  • dizziness
  • headache
  • tinnitus
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9
Q

Loop Diuretics: Adverse Affects to GI system

A

nausea, vomiting, diarrhea

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10
Q

Loop Diuretics: Adverse Affects to Integumentary System

A

stevens-johnson syndrome (torsemide)

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11
Q

Loop Diuretics: Adverse Affects to Hematologic

A

Agranulocytosis, neutropenia, thrombocytopenia

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12
Q

Loop Diuretics: Adverse Affects to Metabolic System

A

hypokalemia, hyperglycemia and hyperuricemia

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13
Q

Potassium-Sparing Diuretics

A

-amiloride
-spironolactone
-triamterene
aka aldosterone-inhibiting diuretics

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14
Q

Mechanism of Action: Potassium-Sparing Diuretics

A

blocks aldosterone action in the kidney

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15
Q

Potassium-Sparing Diuretics: Drug Effects

A
  • Prevent potassium from being pumped into the tubule, thus preventing its secretion
  • Competitively block aldosterone receptors and inhibit their action
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16
Q

Potassium-Sparing Diuretics: Indications

A
  • spironolactone and triamterene:
    • Hyperaldosteronism
    • Hypertension
    • Reversing potassium loss caused by potassium-losing drugs
    • Certain cases of CHF
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17
Q

Potassium-Sparing Diuretics: Adverse Effects on CNS

A

dizziness, headache

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18
Q

Potassium-Sparing Diuretics: Adverse Effects on GI

A

cramps, nausea, vomiting, diarrhea

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19
Q

Potassium-Sparing Diuretics: Adverse Effects on other systems

A

urinary frequency, weakness, and hyperkalemia

20
Q

Potassium-Sparing Diuretics: Adverse Effects due to spironolactone

A

gynecomastia, irregular menses

21
Q

Thiazide diuretics include

A
  • hydrochlorothiazide

- Chlorothiazide

22
Q

Thiazide-like diuretics include

A
  • metolazone
  • chlorthalidone
  • indapamide
23
Q

Mechanism of Action: Thiazide and Thiazide-like Diuretics

A

Inhibit tubular resorption of sodium, chloride, and potassium ions

24
Q

Thiazide and Thiazide-like Diuretics: Drug Effects

A
  • Works primarily in the distal convoluted tubule
  • Excretion of water, sodium, and chloride
  • Lowered peripheral vascular resistance
25
Q

Thiazide and Thiazide-like Diuretics: Indications

A
  • Hypertension
  • Edema
  • Hypercalciuria
  • Congestive Heart failure
  • Ascites related to HF, hepatic cirrhosis
26
Q

Thiazide and Thiazide-like Diuretics: Adverse Effects on CNS

A

dizziness, headache, blurred vision

27
Q

Thiazide and Thiazide-like Diuretics: Adverse Effects on GI

A

anorexia, nausea, vomiting, diarrhea

28
Q

Thiazide and Thiazide-like Diuretics: Adverse Effects on GU

A

impotence

29
Q

Thiazide and Thiazide-like Diuretics: Adverse Effects on Hematologic

A

jaundice, leukopenia

30
Q

Thiazide and Thiazide-like Diuretics: Adverse Effects on integumentary

A

urticaria, photosensitivity

31
Q

Thiazide and Thiazide-like Diuretics: Adverse Effects on metabolic system

A

hyperglycemia, hyperuricemia, hyponatremia

32
Q

Nursing Process: Assess

A
  • perform thorough patient history and physical examination
  • assess baseline fluid volume status, intake and output, serum electrolyte values, weight, and vital signs—especially postural BPs
  • Assess for disorders that may contraindicate or necessitate cautious use of these drugs
33
Q

During diuretic therapy, the nurse should

A
  • instruct patients to take the medication in the morning if possible to avoid interference with sleep patterns
  • monitor serum potassium levels during therapy
  • monitor adverse effects
  • monitor for therapeutic effects
34
Q

What should the nurse teach the patient going through diuretic drug therapy?

A
  • teach patients to maintain proper nutritional and fluid volume status
  • to eat more potassium-rich foods when taking anything but the potassium-sparing drugs
35
Q

Food high in potassium include

A

bananas, oranges, dates, apricots, raisins, broccoli, green beans, potatoes, meats, fish, and legumes

36
Q

Patients taking diuretics along with a digitalis preparation should

A

be taught to monitor for digitalis toxicity

37
Q

Patients with diabetes mellitus who are taking thiazide and/or loop diuretics should

A

be told to monitor blood glucose and watch for elevated levels

38
Q

Why should a nurse teach patients to change positions slowly and to rise slowly after sitting or lying down?

A

to prevent dizziness and fainting related to orthostatic hypotension

39
Q

The nurse should encourage patients to

A

keep a log of their daily weight and remind them to return for follow-up visits and lab work.

40
Q

Patients who have been ill with nausea, vomiting and/or diarrhea should

A

-notify their primary care provider because fluid and electrolyte balances can result.

41
Q

Signs and symptoms of hypokalemia include

A

muscle weakness, constipation, irregular pulse rate, and overall feeling of lethargy

42
Q

What should the nurse advise the patient to do if they are experiencing rapid heart rates or syncope (reflects hypotension or fluid loss)?

A

to notify their primary care provider immediately

43
Q

Excessive consumption of licorice can lead to

A

additive hypokalemia in patients taking thiazides

44
Q

What should the nurse monitor for in patients taking potassium-sparing diuretics?

A

hyperkalemia

45
Q

Adverse Effects when taking Diuretics

A

Metabolic alkalosis, drowsiness, lethargy, hypokalemia, tachycardia, hypotension, leg cramps, restlessness, decreased mental alertness

46
Q

When monitoring for therapeutic effects of diuretic therapy, the nurse should look at…

A
  • Reduction of edema
  • Reduction of fluid volume overload
  • Improvement in manifestations of heart failure
  • Reduction of hypertension
  • Return to normal intraocular pressures

NURS 306 (26 decks)

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