Diuretics Flashcards by Sarah Mortimer

General diuretic assessment?

Daily weight

I&O

Edema

Skin turgor

Diaphoretic

Mucous membranes

Electrolyte swings

How well did you know this?

Not at all

Perfectly

Fluid overload signs?

Altered mental status

Crackles

Jugular venous pressure goes up

Increased body weight

Increased BP

pitting edema

Altered capillary refill

Anasarka

How well did you know this?

Not at all

Perfectly

Diuretic vital assessment?

Assess for fluid overload

Lung sounds for crackles

BP for hypertension

JVD

too much fluid removed

How well did you know this?

Not at all

Perfectly

Too much fluid removed signs?

Hypotension

Tachycardia

dry mucous membranes

Dizziness

Skin tenting

How well did you know this?

Not at all

Perfectly

Furosemide drug class?

Loop diuretic

How well did you know this?

Not at all

Perfectly

Furosemide admin?

PO or IV

How well did you know this?

Not at all

Perfectly

What is Furosemide for?

Great for pulmonary edema

Can be used with low GFR

CHF

hypertension

How well did you know this?

Not at all

Perfectly

Furosemide labs?

BUN
electrolytes
Glucose

How well did you know this?

Not at all

Perfectly

Furosemide assessment?

Swelling of extremities

Lung crackles

Short of breath

I&O

How well did you know this?

Not at all

Perfectly

Special populations for Furosemide?

Children- Adverse effects can be sudden

Adults- prolonged use ok, chronic use teaching

OA- caution due to higher risk of cardiac/renal/liver impairment

Hepatic failure- used to treat ascites

Critically ill- severe edema in ICU

How well did you know this?

Not at all

Perfectly

Furosemide adverse effects?

Ototoxicity

Decreased sodium, potassium, and fluid volume

How well did you know this?

Not at all

Perfectly

Furosemide contras?

Sensitivity to drug

Anuria

Allergy to sulfonamides

Pregnancy unless benefits outweigh risk to fetus

How well did you know this?

Not at all

Perfectly

Furosemide nursing considerations?

Caution in other nephrotoxic drugs

Can cause hyperglycemia

Decreased antibiotic effect

How well did you know this?

Not at all

Perfectly

Furosemide admin?

IVP over 1-2 minutes (max- 20 mg/min) prevents ototoxicity

How well did you know this?

Not at all

Perfectly

Furosemide teaching?

Potassium rich, low sodium diet

Dosage timing

Signs of fluid excess/deficit

Photosensitivity

Dizziness if used for hypertension

Caution with digoxin and diabetes meds

Daily weight

How well did you know this?

Not at all

Perfectly

Hydrochlorothiazide drug class?

Thiazide diuretic

How well did you know this?

Not at all

Perfectly

What is special about hydrochlorothiazide?

It’s not as strong as furosemide and is the 2nd choice diuretic

How well did you know this?

Not at all

Perfectly

Hydrochlorothiazide uses?

Chronic edema in heart failure and nephrotic syndrome

Mild to moderate hypertension

How well did you know this?

Not at all

Perfectly

How is hydrochlorothiazide given?

What are labs to monitor with hydrochlorothiazide?

Fluid and electrolytes

Sodium levels

EKG

Glucose

Special populations for hydrochlorothiazide?

Children: used for chronic lung disease

Used more often

Less side effects than adults

Older adults: caution due to more sensitivity to hypotension and electrolyte imbalances- use smallest effective dose

Hepatic impairment- risk of elevated ammonia levels

What is important to know about hydrochlorothiazide regarding how long it takes to work?

They’re not as fast as loop diuretics

Adverse effects of hydrochlorothiazide?

Hypotension

Dizziness

Bowel changes

Lowered sodium, potassium, and chloride

Hyperglycemia

Erectile dysfunction

Contraindications for hydrochlorothiazide?

Sensitivity to sulfonamides

Anura

Pregnancy

Spironolactone drug class?

Potassium sparing diuretic

What is the MOA of spironolactone?

Reduces retention of sodium and water

What drug is k sparing and what does it mean?

Spironolactone Drug reduces urinary potassium loss

What is different about Spironolactone?

It’s a weak diuretic and often has to be used in combination with others

How long does Spironolactone take to work?

Takes day to take full effect

What are the uses for Spironolactone?

Heart failure Ascites in liver disease Hypertension Hypokalemia Hyperaldosteronism Hypertension

What are special population considerations for sprironolactone?

Children- take with food Discontinue in renal failure Caution with hepatic impairment Better diuretics in critical illness

Adverse effects of Spironolactone?

Dizziness, headache, abdominal cramping, diarrhea, Androgen receptor effects: deepening voice, gynecomastia, menstrual irregularity, testicular hypertrophy

Black box warning for Spironolactone?

Unnecessary use avoided Tumorigenic with chronic toxicity

Contraindications for Spironolactone?

Renal insufficiency First trimester pregnancy Caution with Dixogin and lithium

Spironolactone assessment?

Frequent BP and HR LOC abdomen assessment I&O Daily weight Decreased edema Fall risk assessment

Labs for spironolactone?

CMR and GFR

What increases the effects of Spironolactone?

Beta blockers- hyperglycemia Other drugs that raise potassium (hyperkalemia)

What decreases the effects of Spironolactone?

Alcohol Anti hypertensive drugs Salicylates

Spironolactone teaching?

No salt substitutes Risk of dizziness/drowsiness Risk of hypertension with drugs that raise potassium

What drug class is mannitol?

Osmotic diuretic

What part of the nephron does mannitol work?

Loop of henle and proximal convoluted tubule

How fast does mannitol work?

Very rapid diuresis

When is mannitol used?

When GFR is reduced For oliguria or anuria Cerebral edema Intraocular pressure Excretion of toxic substances (drug overdose) Can prevent renal failure by flushing kidneys of cellular debris

Mannitol assessment?

I&O daily weight Electrolytes capillary refill Edema

What are some nursing considerations for mannitol?

Does work with reduced GFR Very rapid fluid shift- risk of pulmonary edema, heart failure

What is a special consideration for Diphenoxylate/atropine?

Alcohol increases the sedative effect