diuretics

Question 1

function of diuretics

Answer 1

• modify renal function to accelerate rate of urine formation
• increase excretion of water and electrolytes by inhibiting Na and H2O resorption within the nephron
• decrease reabsorption of na, cl, water, and other substances
• reduces extracellular fluid volume, plasma volume, and co

Question 2

indications of diuretics

Answer 2

• alteration in renal
• cardiovascular, renal and hepatic conditions
• burns and trauma
• edema (peripheral, pulmonary, cerebral)

Question 3

ae of diuretics

Answer 3

• hypotension

- potassium imbalances

Question 4

types of diuretics

Answer 4

• loop
• thiazide
• postassium-sparing
• osmotic
• combination

Question 5

loop diuretic drugs

Answer 5

• fureosemide
• bumetanide
• torsemide

Question 6

loop diuretic moa

Answer 6

inhibits sodium and chloride reabsorption in the ascending loop of henle

Question 7

uses of loop diuretics

Answer 7

• alone or in combo for htn treatment
• pulmonary edema
• chf
• ascites
• low GFR

Question 8

loop diuretic implications

Answer 8

• don’t admin IVP to quickly, can develop ototoxicity, shown as tinnitus, no faster than 4mg/min
• monitor k levels for digoxin toxicity

Question 9

loop diruetic ae

Answer 9

• electrolyte imbalances (na, k)
• fluid volume deficit
• digoxin toxicity

Question 10

loop diuretics cautions

Answer 10

• sulfa allergy

- pregnancy

Question 11

thiazide diuretic drugs

Answer 11

• hydrochlorothiazide
• metalazone
• chlorthalidone

Question 12

thiazide diuretic uses

Answer 12

• first line treatment for htn
• long term management of heart failure
• slow onset, not for immediate results
• ineffective when gfr <30

Question 13

thiazide diuretic caution and contraindications

Answer 13

• caution in liver patients, risk for thiazide induced (hyokalemic, hypochloremic) acidosis
• contraindicated in pregnancy, anuria, and sulfa allergies

Question 14

thiazide diuretic implications

Answer 14

• monitor for hepatoencephalopathy by monitoring ammonia levels (stroke, confused, lethargic)
• monitor for signs of ototoxicity and dizziness

Question 15

thiazide diuretic interactions

Answer 15

beta blockers can cause hyperglycemia, hyperlipidemia, hyperucermia

Question 16

potassium sparing diuretic drugs

Answer 16

• spironolactone
• amiloride
• triamterene

Question 17

potassium sparing diuretic uses

Answer 17

• heart failure
• ascites
• hypokalemia
• htn
• hyperaldosteronism
• slow onset, weak diuretic effect, 6 weeks for max effect

Question 18

potassium sparing diuretic implications

Answer 18

• monitor for encephalopathy in liver
• use with ace inhibitor to reduce sx and help heart function
• monitor for digoxin toxicity, increases half life of digoxin
• monitor for lithium toxicitym reduces clearance of lithium
• educate no salt, low k level
• take with food, same time daily
• dont give if k levels is >5

Question 19

osmotic diuretic drugs

Answer 19

mannitol (osmitrol)

Question 20

osmotic diuretic moa

Answer 20

increases osmotic pressure of glomerular filtrate causing water to be drawn into the bloodstream from extracellular compartments… resulting in rapid diuresis or loss of water and electrolytes through the kidney

Question 21

osmotic diuretic uses

Answer 21

• oliguria or anuria
• hypovolemic shock, trauma, dehydration
• increased intraocular pressure
• urinary excretion of toxic substances
• main use for increased intracranial pressure before or after neurosurgery
• not indicated for peripheral edma

Question 22

osmotic diuretic implications

Answer 22

• if used to promote UOP, goal is >30 ml/hr
• check solution for crystals and dissolve before giving
• only give iv with filter

Question 23

combination products

Answer 23

• Not indicated for initial therapy of edema or HTN because sometimes have to be titrated specifically for individual
• Can increase compliance
• Can prevent hypokalemia
• if inadequate diuretic effect, loop and thiazide can be taken together

Question 24

nursing assessment for combination products

Answer 24

• Check electrolytes, kidney functions, VS, weight, UOP
• Assess for edema, N/V, abd pain, tenderness, lung sounds, respiration status
• Mental status, pupil reaction, heart rhythm
• Ascites
• Fatigue