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NCLEX > Diuretic Drugs > Flashcards

Diuretic Drugs Flashcards

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0
Q

Furosemide (Lasix)

Chemical Classification

A

Sulfonamide derivative

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1
Q

Furosemide (Lasix)

Functional Classification

A

Loop Diuretic

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2
Q

Furosemide (Lasix)

Mechanism of Action

A

Inhibits reabsorption of sodium and chloride at proximal and distal tubule and in the loop of Henle

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3
Q

Furosemide (Lasix)

Uses

A

Pulmonary edema; edema with CHF, hepatic disease, nephrotic syndrome, ascites, hypertension

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4
Q

Furosemide (Lasix)

Contraindications

A

Breastfeeding, infants, anuria, hypovolemia, electrolyte depletion

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5
Q

Furosemide (Lasix)

Side Effects

A

CNS: headache, fatigue, weakness, vertigo, paresthesias
CV: orthostatic hypotension, chest pain, ECG changes, CIRCULATORY COLLAPSE
EENT: loss of hearing, ear pain, tinnitus, blurred vision
ELECT: Hypokalemia, Hypochloremic Alkalosis, Hypomagnesemia, Hyperuricemia, Hypocalcemia, Hyponatremia, metabolic alkalosis
ENDO: Hyperglycemia
GI: Nausea, diarrhea, dry mouth, vomiting, anorexia, cramps, oral, gastric irritations, pancreatitis
GU: Polyuria, RENAL FAILURE, glycosuria
HEMA: THROMBOCYTOPENIA, AGRANULOCYTOSIS, LEUKOPENIA, NEUTROPENIA, ANEMIA
INTEG: Rash, Pruritus, purpura, STEVENS-JOHNSON SYNDROME, sweating, photosensitivity, urticaria
MS: cramps, stiffness

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6
Q

Furosemide (Lasix)

Nursing Considerations

A

ASSESS:

  • CHF: weight, I&O daily to determine fluid loss; effect of product may be decreased if used daily
  • HYPERTENSION: BP lying, standing; postural hypotension may occur
  • Metabolic alkalosis: drowsiness, restlessness
  • HYPOKALEMIA: postural hypotension, malaise, fatigue, tachycardia, leg cramps, weakness
  • Rashes, temp elevation daily
  • Confusion, especially in geriatric patients; take safety precautions if needed
  • HEARING, including tinnitus and hearing loss, when giving high doses for extended periods
  • Rate, depth, rhythm of respiration, effect of exertion, lung sounds
  • Electrolytes (potassium, sodium, chloride); include BUN, blood glucose, CBC, serum creatinine, blood pH, ABGs, uric acid
  • Glucose in urine if patient diabetic
  • Allergies to sulfonamides, thiazides

PERFORM/PROVIDE
-Increased fluid intake 2-3L/day unless contraindicated

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7
Q

Furosemide (Lasix)

Overdose Treatment

A

Lavage if taken orally; monitor electrolytes; administer dextrose in saline; monitor hydration, CV, renal status

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8
Q

Hydrochlorothiazide

Functional Classification

A

Thiazide diuretic, antihypertensive

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9
Q

Hydrochlorothiazide

Chemical Classification

A

Sulfonamide derivative

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10
Q

Hydrochlorothiazide

Mechanism of Action

A

Acts on distal tubule and ascending limb of loop of Henle by increasing excretion of water, sodium, chloride, potassium

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11
Q

Hydrochlorothiazide

Uses

A

Edema, hypertension, diuresis, CHF; edema in corticosteroid, estrogen, NSAIDs; idiopathic lower extremity edema therapy

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12
Q

Hydrochlorothiazide

Contraindications

A

Hypersensitivity to thiazides or sulfonamides, anuria, renal decompensation, hypomagnesemia

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13
Q

Hydrochlorothiazide

Side Effects

A

CNS: drowsiness, paresthesia, depression, headache, Dizziness, Fatigue, Weakness, fever
CV: irregular pulse, orthostatic hypotension, palpitations, volume depletion, allergic myocarditis
EENT: blurred vision
ELECT: Hypokalemia, hypercalcemia, hyponatremia, hypochloremia, hypomagnesemia
GI: Nausea, Vomiting, Anorexia, constipation, diarrhea, cramps, pancreatitis, GI irritation, HEPATITIS
GU: Urinary Frequency, polyuria, UREMIA, GLUCOSURIA, hyperuricemia
HEMA: APLASTIC ANEMIA, HEMOLYTIC ANEMIA, LEUKOPENIA, AGRANULOCYTOSIS, THROMBOCYTOPENIA, NEUTROPENIA
INTEG: Rash, urticaria, purpura, photosensitivity, alopecia, erythema multiforme
META: Hyperglycemia, Hyperuricemia, increased creatinine, BUN

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14
Q

Hydrochlorothiazide

Nursing Considerations

A

ASSESS:

  • Weight, I&O daily to determine fluid loss; effect of product may be decreased if used daily
  • Rate, depth, rhythm of respiration, effect of exertion
  • BP lying, standing; postural hypotension may occur
  • Blood studies: BUN, blood glucose, CC, serum creatinine, blood pH, ABGs, uric acid, electrolytes
  • SIGNS OF METABOLIC ALKALOSIS: drowsiness, restlessness
  • SIGNS OF HYPOKALEMIA: postural hypotension, malaise, fatigue, tachycardia, leg cramps, weakness, dehydration
  • Confusion, especially in geriatric patients; take safety precautions if needed
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15
Q

Hydrochlorothiazide

Overdose Treatment

A

Lavage if taken orally; monitor electrolytes; administer dextrose in saline; monitor hydration, CV, renal status

16
Q

Mannitol

Functional Classification

A

Diuretic, osmotic

17
Q

Mannitol

Chemical Classification

A

Hexahydric Alcohol

18
Q

Mannitol

Mechanism of Action

A

Acts by increasing osmolarity of glomerular filtrate, which inhibits reabsorption of water and electrolytes and increases urinary output

19
Q

Mannitol

Uses

A

Edema; promotion of systemic diuresis in cerebral edema; decreased in intraocular/intracranial pressure; improved renal function in acute renal failure, chemical poisoning

20
Q

Mannitol

Contraindications

A

Active intracranial bleeding, hypersensitivity, anuria, severe pulmonary congestion, edema, severe dehydration, progressive heart, renal failure

21
Q

Mannitol

Side Effects

A

CNS: dizziness, headache, SEIZURES, REBOUND INCREASED ICP, confusion
CV: edema, thrombophlebitis, hypo/hypertension, TACHYCARDIA, angina-like chest pains, fever, chills, CHF, CIRCULATORY OVERLOAD
EENT: loss of hearing, blurred vision, nasal congestion, decreased intraocular pressure
ELECT: fluid, electrolyte imbalances, Acidosis, electrolyte loss, dehydration, hypo/hyperkelemia
GI: Nausea, Vomiting, dry mouth, diarrhea
GU: marked diuresis, urinary retention, thirst
RESP: pulmonary congestion

22
Q

Mannitol

Nursing Considerations

A

ASSESS:

  • Weight, I&O daily to determine fluid loss; effect of product may be increased if used daily; output every hour prn
  • Rate, depth, rhythm of respiration, effect of exertion
  • BP lying, standing; postural hypotension may occur
  • Electrolytes: potassium, sodium, chloride; include BUN, CBC, serum creatinine, blood pH, ABGs, CVP, PAP
  • METABOLIC ACIDOSIS: drowsiness, restlessness
  • HYPOKALEMIA: postural hypotension, malaise, fatigue, tachycardia, leg cramps, weakness, or hyperkalemia
  • rashes, temp daily
  • confusion, especially in geriatric patients; take safety precautions if needed
  • Hydration including skin turgor, thirst, dry mucous membranes
  • Blurred vision, pain in eyes before, during treatment (INCREASED INTRAOCULAR PRESSURE); neurologic checks, intracranial pressure during treatment (INCREASED INTRACRANIAL PRESSURE)
23
Q

Mannitol

Overdose treatment

A

Discontinue inf; correct fluid, electrolyte imbalances; hemodialysis, monitor hydration, CV status, renal function

24
Q

Spironolactone (Aldactone)

Functional Classification

A

Potassium-Sparing Diuretic

25
Q

Spironolactone (Aldactone)

Chemical Classification

A

Aldosterone Antagonist

26
Q

Spironolactone (Aldactone)

Mechanism of Action

A

Completes with aldosterone at receptor sites in distal tubule, thereby resulting in the excretion of sodium chloride and water and the retention of potassium and phosphate

27
Q

Spironolactone (Aldactone)

Uses

A

edema of CHF, hypertension, diuretic-induced hypokalemia, primary hyperaldosteronism (diagnosis, short-term treatment, long-term treatment), edema of nephrotic syndrome, cirrhosis of liver with ascites

28
Q

Spironolactone (Aldactone)

Contraindications

A

Pregnancy (D), hypersensitivity, anuria, severe renal disease, hyperkalemia

29
Q

Spironolactone (Aldactone)

Side Effects

A

CNS: Headache, confusion, drowsiness, lethargy, ataxia,
ELECT: hyperchloremic metabolic acidosis, HYPERKALEMIA, hyponatremia
ENDO: impotence, gynecomastia, irregular menses, amenorrhea, postmenopausal bleeding, hirsutism, deepening voice, breast pain
GI: Diarrhea, cramps, BLEEDING, gastritis, Vomiting, anorexia, nausea, HEPATOCELLULAR TOXICITY
HEMA: AGRANULOCYTOSIS
INTEG: Rash, Pruritus, urticaria

30
Q

Spironolactone (Aldactone)

Nursing Considerations

A

ASSESS:

  • HYPOKALEMIA: polyuria, polydipsia; dysrhythmias, including a u wave on ECG
  • HYPERKALEMIA: weakness, fatigue, dyspnea, dysrhythmias, confusion, fatigue
  • Electrolytes: sodium, chloride, potassium, BUN, serum creatinine, ABGs, CBC
  • Weight, I&O daily to determine fluid loss; effect of product may be decreased if used daily; ECG periodically with long-term therapy
  • Signs of metabolic acidosis: drowsiness, restlessness
  • Rashes,temp daily
  • Confusion, especially in geriatric patients; take safety precautions if needed
  • Hydration: skin turgor, thirst, dry mucous membranes
31
Q

Spironolactone (Aldactone)

Overdose Treatment

A

Lavage if taken orally; monitor electrolytes, administer IV fluids, monitor hydration, renal, CV status

NCLEX (40 decks)

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