Chapter 43 Diuretics

Question 1

Types of Diuretics

Answer 1

• Thiazide and thiazide-like
• Loop or high-ceiling
• Osmotic> water fluids increase
• Carbonic anhydrase inhibitor
• Potassium-sparing

Question 2

Diuretics

Answer 2

Purposes of diuretics

• Lowered blood pressure
• Decreased edema

Question 3

*Thiazide and Thiazide-Like Diuretics

Answer 3

• Chlorothiazide (Diuril)
• Hydrochlorothiazide (HCTZ)
• Bendroflumethiazide with nadolol (Corzide)
• Methyclothiazide (Enduron)
• Chlorthalidone (Thalitone)
• Indapamide (Lozol)
• Metolazone (Zaroxolyn)

Question 4

*Nursing Process: Thiazides

Answer 4

• Assessment
• Nursing diagnoses
• Planning
• Nursing interventions
• Patient teaching
• Cultural considerations
• Evaluation

Question 5

*Loop Diuretics

Answer 5

• Loop diuretics: ethacrynic acid (Edecrin), furosemide (Lasix), bumetanide (Bumex)
• Action
• Laboratory changes associated with loop diuretics:
• Hypokalemia, hyponatremia, hypocalcemia, hypomagnesemia, hypochloremia
• Hyperglycemia possible in diabetic patients
• Hyperuricemia
• Elevated blood urea nitrogen and creatinine
• Elevated lipids
• Thrombocytopenia, leukopenia

Question 6

*Loop Diuretics (Cont.) side effects

Answer 6

• Side effects and adverse reactions
• Fluid and electrolyte imbalances
• Hypochloremic metabolic alkalosis
• Orthostatic hypotension
• Thrombocytopenia
• Skin disturbances
• Transient deafness
• Thiamine deficiency

Question 7

*Osmotic Diuretics

Answer 7

• Osmotic diuretics: mannitol (Osmitrol)
• Action
• Use: Prevent kidney failure, decrease ICP, and decrease IOP
• Side effects/adverse reactions: fluid and electrolyte imbalance, pulmonary edema, nausea, vomiting, tachycardia, and acidosis
• Crystallization of mannitol
• Contraindications: Heart failure, renal failure

Question 8

*Carbonic Anhydrase Inhibitors

Answer 8

• Carbonic anhydrase inhibitors: acetazolamide, dichlorphenamide, ethoxzolamide, and methazolamide
• Action
• Used primarily to decrease IOP in patients with open-angle (chronic) glaucoma
• Side effects/adverse reactions: fluid and electrolyte imbalance, metabolic acidosis, nausea, vomiting, anorexia, confusion, orthostatic hypotension, crystalluria, hemolytic anemia, and renal calculi

Question 9

*Potassium-Sparing Diuretics

Answer 9

• Potassium-sparing diuretics: spironolactone (Aldactone), amiloride (Midamor), triamterene (Dyrenium), and eplerenone (Inspra)
• Action
• Hyperkalemia
• Effects when given with ACE inhibitors