Diuretics (43) Flashcards
Diuretics remove ____ from the body. Used on clients with ____ and ____.
sodium… edema… hypertension.
Regulation of Sodium balance by kidneys is determined by ____, ____, and ____.
GFR… aldosterone… baroreceptors.
Diuretics promote excretion of sodium by ____ its absorption.
inhibiting.
5 categories of diuretics:
- Thiazide & thiazide-like
- Loop
- Osmotic
- Carbonic anhydrase inhibitor
- Potassium-sparing.
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Adverse effects of diuretics:
Hypokalemia:
Large concentration of ____ reaches the distal ____ –> greater ____ exchange ocurring –> ____ depletion.
sodium… tubules… sodium-potassium… potassium
Adverse Effects of Diuretics:
- If large amount of chloride excreted –> ____ depletion and metabolic ____.
- Hypercalcemia - d/t loss of sodium, potassium, and magnesium… Promotes ____ reabsorption.
chloride… alkalosis… calcium
Prolonged Tx: ____ and ____ supplements.
potassium… chloride.
Other adverse effects of diuretics:
hyper____, hyper____, ____.
glycemia… uricemia… sensitivity
Examples of diuretics:
chlorothiazide (Diuril)
Hydrochlorothiazide - HCTZ (Hydrodiuril)
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Monitor vital signs while on diuretics:
Serum electrolytes:
Potassium: 3.5-5.0
Glucose: 70-100
Uric Acid: 3.0-7.0
KNOW THE NUMBERS
Observe for s/s of hypo____ (muscle weakness, leg ____, cardiac ____. Also watch weight daily and ____ output.
kalemia… cramps… dysrhythmias… urine.
Take diuretics early in the ____. If orthostatic hypotension happens, change position slowly. Eat ____ rich foods and watch for ____ (take with food)
morning… potassium… GI upset
Loop Diuretics inhibit reabsorption of sodium & chloride in ____ and reduces kidney’s ability to ____ urine.
ascending loop of Henle… concentrate.
Loop diuretics are more ____ than thiazide diuretics, less ____ as an antihypertensive, and for clients with impaired ____.
potent… effective… GFR
Adverse effects of loop diuretics:
Electrolyte ____, ____ hypotension, and ____ with aminoglycosides.
imbalances… orthostatic… ototoxicity.
Digoxin –> digitalis toxicity.
Hypokalemia enhances action of ____ –> increase risk for ____.
Licorice can increase ____ loss –> ____.
digoxin… toxicity… potassium… hypokalemia.
Examples of loop diuretics:
Furosemide (Lasix)
Bumetanide ( Bumex)
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Note onset of drug action of loop diuretics:
Increase in urine output:
Oral within ____.
IV within ____ (If not, notify health care provider)
1 hour… 5-20 minutes
Nursing Interventions for diuretics: I&O Weight \_\_\_\_ Adm \_\_\_\_ slowly
Vital signs… IV furosemide
S/S hypokalemia (less than 3.5) - muscle weakness, leg cramps, cardiac dysrhythmias.
Monitor ____
serum K+
Take loop diuretics in ____, take with food, and change ____ slowly.
morning… positions.
Osmotic diuretics are mainly use to treat increased ____ & ____ pressure and prevent acute ____.
intracranial… intraocular…renal failure.
Mannitol (IV) is a powerful diuretic (osmotic)
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Carbonic Anhydrase inhibitors are used to treat ____.
intraocular pressure
Potassium-sparing diuretics are not as ____ as thiazide or loop diuretics and combine with another ____ or ____ drug
strong… diuretic… antihypertensive.
Aldosterone mineralocorticoid hormone promotes ____ retention & ____ excretion.
Na+… K+
Potassium-sparing diuretics block action of ____ and inhibit ____ excretion (combined with ____ - depleting diuretic to decrease occurrence of ____)
aldosterone… K+… potassium… hypokalemia
Adverse effect of potassium-sparing diuretics:
Hyperkalemia - do not use ____ supplements with ____ diuretics.
K+… K+ sparing.
Examples of potassium-sparing diuretics:
spironolactone (Aldactone) - inhibits action of ____.
triamterene ( Dyrenium)
amiloride (Midamor)
aldosterone
While on potassium sparing diuretics, monitor urinary output. Report if less than ____ or less than ____.
30mL/hour… 60mL/24 hours.
Observe for s/s of hyperkalemia - nausea, ____, abd cramps, numbness, tingling, ____.
diarrhea… tachycardia.
Take potassium sparing diuretics with or after meals, do not d/c without consulting health care provider, avoid exposure to direct sunlight d/t ____, and avoid foods high in ____.
photosensitivity… K+
