Chapter 32 and 33 Diuretics and Electrolytes Flashcards
what are the three major endocrine functions of the kidneys*
Renin
Erythropoietin
Calcitriol
what is the function of renin*
Renin starts a chain reaction that ultimately results in the production of Angiotensin II which narrows blood vessels and releases aldosterone
What effect does aldosterone have on the body*
Aldosterone helps your body retain water and salt which both increase the amount of water in your body
what is the function of calcitriol*
it stimulates the intestines to uptake more calcium
What are 3 common adverse effects of diuretic therapy**
Electrolyte imbalance
Dehydration
Hypotension
How do loop Diuretics work*
they block Na and chloride reabsorption in the loop of henle
What are two indications for loop diuretics **
Edema and CHF
what are the two routes of administration for loop diuretics**
Oral or parenteral
what is one adverse effect of loop diuretics
ototoxicity
is it safe to give loop diuretics to a person with a sulfonamide allergy
no this is a contraindication of loop diuretics
what are 4 nursing considerations when administering loop diuretics
-Establish safety precautions
-Ensure ready access to a bathroom
-Administer early in the day
-Watch K+ levels
What is a drug that is similar to furosemide***
-Bumetanide (Bumex)
what are two indications for Bumetanide *
Ascites
Peripheral edema
which loop diuretic causes the most significant hearing loss
Ethacrynic acid (edecrin)
do thiazides cause ototoxicity
NO
How do Thiazide diuretics work
Acts on distal tubule to decrease reabsorption of sodium
What is the treatment for a thiazide overdose**
Infusion of fluids containing electrolytes
What are 4 considerations when a patient is taking thiazide**
-Encourage water ofer caffeine drinks
-use caution with electrolyte drinks
-monitor serum electrolytes
-monitor I&O
what pregnancy category is thiazide**
Category B
What is the mechanism of action for potassium sparring diuretics
inhibits the action of aldosterone on the distal tubule and collecting ducts
What is an indication for potassium sparring diuretics
Mild HTN
What are 5 drug interactions for PSD**
-ammonium chloride drugs (because it causes acidosis)
-Aspirin decreases effectiveness
-PSD’s decrease the effectiveness of digoxin
-Hyperkalemia if taken with potassium supplements ACE inhibitors and ARB’s
-additivehypotenshion with other BP meds
what is the prototype drug for PSD’s with its brand name
Spironolactone (aldactone)
What percentage of the body’s water is in intracellular fluid**
2/3 (65%)
what percentage of the body’s water is in the extracellular fluid**
1/3 (35%)
what is the major electrolyte of the extracellular fluid
Na
What is the normal range for sodium levels **
135 mEq/L-145 mEq/L
what is the prototype drug to treat hyponatremia
sodium chloride
What are 5 adverse effects of sodium chloride **
-lethargy
-confusion
-muscle tremor or rigidity
-hypertenshion
-pulmonary edema
what is a key hormone to maintain potassium levels **
insulin because it lowers blood potassium levels by driving it into cells
what is the lab value for hyperkalemia**
Serum levels greater than 5 mEq/L
what is the lab value for hypokalemia***
serum levels less than 3.5 mEq/L
what are two reasons you would administer potassium supplements**
hypokalemia
treat mild alkalosis (because potassium ions cause hydrogen ions to shift more potassium=more acidic)
What is the maximum rate you can infuse potassium
10 mEq/h
What problems can a magnesium imbalance cause**
significantly affect cardiovascular and neuromuscular function
what organ are the magnesium levels of the body controlled by**
Mag levels are controlled by the kidneys
what is the healthy range for magnesium levels and in what units ***
0.65 mmol/L-1.05 mmol/L
what are two common causes of hypomagnesemia **
Renal problems
loop diuretics
what is the major cause of hypermagnesemia **
Advanced renal failure
what is the second most abundant intracellular cation**
Mag
What are 4 adverse effects of magnesium imbalance **
-flushing of the skin
-confusion/sedation
-thirst
-muscle weakness
what are 4 SERIOUS adverse effects of a magnesium imbalance**
-neuromuscular blockade
-Respiratory paralysis
-Heart block (heart electric impulse blocked)
-circulatory collapse/shock
what is the most abundant mineral in the body**
Ca
what is the ideal calcium range with its units**
2.1 mmol/L - 2.5 mmol/L
what is a common cause of hypercalcemia**
overactive parathyroid gland
What are two major causes of hypocalcemia ***
Lack of vit D
hypothyroidism
what are two serious adverse effects of calcium imbalance ***
Dysrhythmias
Cardiac arrest
What are some major contraindications for calcium supplementation ***
-Digoxin toxicity
-hyperphosphatemia
-cardiac abnormalities due to hypercalcemia
why is hyperphosphatemia a contraindication for calcium supplementation
if there is too much phosphorus it will bind with calcium and form an insoluble compound that will calcify organs
