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Pharm > Diuretics > Flashcards

Diuretics Flashcards

1
Q

General diuretic assessment?

A

Daily weight

I&O

Edema

Skin turgor

Diaphoretic

Mucous membranes

Electrolyte swings

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2
Q

Fluid overload signs?

A

Altered mental status

Crackles

Jugular venous pressure goes up

Increased body weight

Increased BP

pitting edema

Altered capillary refill

Anasarka

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3
Q

Diuretic vital assessment?

A

Assess for fluid overload

Lung sounds for crackles

BP for hypertension

JVD

too much fluid removed

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4
Q

Too much fluid removed signs?

A

Hypotension

Tachycardia

dry mucous membranes

Dizziness

Skin tenting

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5
Q

Furosemide drug class?

A

Loop diuretic

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6
Q

Furosemide admin?

A

PO or IV

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7
Q

What is Furosemide for?

A

Great for pulmonary edema

Can be used with low GFR

CHF

hypertension

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8
Q

Furosemide labs?

A

BUN
electrolytes
Glucose

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9
Q

Furosemide assessment?

A

Swelling of extremities

Lung crackles

Short of breath

I&O

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10
Q

Special populations for Furosemide?

A

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

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11
Q

Furosemide adverse effects?

A

Ototoxicity

Decreased sodium, potassium, and fluid volume

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12
Q

Furosemide contras?

A

Sensitivity to drug

Anuria

Allergy to sulfonamides

Pregnancy unless benefits outweigh risk to fetus

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13
Q

Furosemide nursing considerations?

A

Caution in other nephrotoxic drugs

Can cause hyperglycemia

Decreased antibiotic effect

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14
Q

Furosemide admin?

A

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

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15
Q

Furosemide teaching?

A

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

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16
Q

Hydrochlorothiazide drug class?

A

Thiazide diuretic

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17
Q

What is special about hydrochlorothiazide?

A

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

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18
Q

Hydrochlorothiazide uses?

A

Chronic edema in heart failure and nephrotic syndrome

Mild to moderate hypertension

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19
Q

How is hydrochlorothiazide given?

A

PO

20
Q

What are labs to monitor with hydrochlorothiazide?

A

Fluid and electrolytes

Sodium levels

EKG

Glucose

21
Q

Special populations for hydrochlorothiazide?

A

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

22
Q

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

A

They’re not as fast as loop diuretics

23
Q

Adverse effects of hydrochlorothiazide?

A

Hypotension

Dizziness

Bowel changes

Lowered sodium, potassium, and chloride

Hyperglycemia

Erectile dysfunction

24
Q

Contraindications for hydrochlorothiazide?

A

Sensitivity to sulfonamides

Anura

Pregnancy

25
Q

Spironolactone drug class?

A

Potassium sparing diuretic

26
Q

What is the MOA of spironolactone?

A

Reduces retention of sodium and water

27
Q

What drug is k sparing and what does it mean?

A

Spironolactone

Drug reduces urinary potassium loss

28
Q

What is different about Spironolactone?

A

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

29
Q

How long does Spironolactone take to work?

A

Takes day to take full effect

30
Q

What are the uses for Spironolactone?

A

Heart failure

Ascites in liver disease

Hypertension

Hypokalemia

Hyperaldosteronism

Hypertension

31
Q

What are special population considerations for sprironolactone?

A

Children- take with food

Discontinue in renal failure

Caution with hepatic impairment

Better diuretics in critical illness

32
Q

Adverse effects of Spironolactone?

A

Dizziness, headache, abdominal cramping, diarrhea,

Androgen receptor effects: deepening voice, gynecomastia, menstrual irregularity, testicular hypertrophy

33
Q

Black box warning for Spironolactone?

A

Unnecessary use avoided

Tumorigenic with chronic toxicity

34
Q

Contraindications for Spironolactone?

A

Renal insufficiency

First trimester pregnancy

Caution with Dixogin and lithium

35
Q

Spironolactone assessment?

A

Frequent BP and HR

LOC

abdomen assessment

I&O

Daily weight

Decreased edema

Fall risk assessment

36
Q

Labs for spironolactone?

A

CMR and GFR

37
Q

What increases the effects of Spironolactone?

A

Beta blockers- hyperglycemia

Other drugs that raise potassium (hyperkalemia)

38
Q

What decreases the effects of Spironolactone?

A

Alcohol

Anti hypertensive drugs

Salicylates

39
Q

Spironolactone teaching?

A

No salt substitutes

Risk of dizziness/drowsiness

Risk of hypertension with drugs that raise potassium

40
Q

What drug class is mannitol?

A

Osmotic diuretic

41
Q

What part of the nephron does mannitol work?

A

Loop of henle and proximal convoluted tubule

42
Q

How fast does mannitol work?

A

Very rapid diuresis

43
Q

When is mannitol used?

A

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

44
Q

Mannitol assessment?

A

I&O

daily weight

Electrolytes

capillary refill

Edema

45
Q

What are some nursing considerations for mannitol?

A

Does work with reduced GFR

Very rapid fluid shift- risk of pulmonary edema, heart failure

46
Q

What is a special consideration for Diphenoxylate/atropine?

A

Alcohol increases the sedative effect

Pharm (9 decks)

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