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320 Pharmacology > Diuretics & Electrolytes > Flashcards

Diuretics & Electrolytes Flashcards

1
Q

List the types of Diuretic Drugs.

A
  • Carbonic anhydrase inhibitors (CAIs)
  • Loop diuretics
  • Potassium-sparing diuretics
  • Thiazide diuretics
  • Thiazide-like diuretics
  • Osmotic diuretics (not for HTN)
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2
Q

What is an example of a Carbonic Anhydrase Inhibitor (CAI)?

A

acetazolamide

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3
Q

Acetazolamide nursing considerations?

A
  • Assess for allergies to sulfonamides
  • Encourage fluids to 2000-3000 mL/day, unless contraindicated to prevent crystalluria and stone formation
  • A potassium supplement w/o chloride should be administered concurrently
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4
Q

What are some examples of Loop Diuretics?

A
  • Furosemide
  • Bumetanide
  • Torsemide
  • Ethacrynic acid
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5
Q

Loop Diuretics mechanism of action?

A

Increases renal excretion of water, sodium, chloride, magnesium, potassium, and calcium

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6
Q

Furosemide drug profie?

A

Black box warning regarding fluid and electrolyte loss

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7
Q

Furosemide nursing considerations?

A
  • Monitor BP before you administer the medication; hold of <90/60 mm Hg
  • Monitor serum electrolytes, renal labs, liver enzymes, serum glucose and uric acid levels
    ~ commonly causes hypokalemia
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8
Q

What are some examples of Potassium-Sparing Diuretics?

A
  • Spironolactone
  • Triamterene
  • Amiloride
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9
Q

Spironolactone drug profile?

A
  • Monitor serum potassium levels frequently
  • Unlabeled use: hormone replacement therapy for transgender females (male-to-female)
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10
Q

Spironolactone nursing considerations?

A
  • Monitor BP before you administer the medication; hold of < 90/60 mm Hg
  • Caution clients to avoid salt substitutes and foods that contain high levels of potassium
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11
Q

What are some examples of Thiazide Diuretics?

A
  • Hydrochlorothiazide (HCTZ)
  • Chlorothiazide
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12
Q

What are some examples of Thiazide-Like Diuretics?

A
  • Metolazone
  • Chlorthalidone
  • Indapamide
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13
Q

Thiazide and Thiazide-Like Diuretics nursing considerations?

A

Assess client for cues of hypokalemia

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14
Q

What is an example of an Osmotic Diuretic?

A

Mannitol

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15
Q

Mannitol drug profile?

A

Treatment is terminated if cardiac arrest or severe renal impairment develops after initiation in therapy

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16
Q

Mannitol nursing considerations?

A
  • Monitor VS, urine output hourly
  • Assess patient for cues of dehydration, fluid overload, hyperkalemia
17
Q

What is the normal range for Potassium?

A

3.5 to 5 mEq/L

18
Q

What is hypokalemia?

A

Serum K+ is 3.5 mEq/L or lower

19
Q

Describe early and late symptoms of hypokalemia.

A

Early symptoms include:

  • Hypotension
  • Lethargy
  • Mental confusion
  • Muscle weakness

Late symptoms include:

  • Cardiac irregularities
  • Neuropathies
  • Paralytic ileus
20
Q

What serious adverse effect can hypokalemia cause?

A

a low serum potassium can increase toxicity associated with digoxin which can precipitate serious ventricular dysrhythmias

21
Q

What is hyperkalemia?

A

Serum K+ is 5.0 mEq/L or higher

22
Q

What are some symptoms of hyperkalemia?

A
  • Fatigue
  • Paresthesia
  • Palpitations
  • Paralysis
  • Clinical manifestations can precipitate to the heart
23
Q

Describe PO Potassium.

A

Very irritating to GI tract (can cause ulcers)

24
Q

Describe IV Potassium.

A

Generally, infusion no faster than 10 mEq/hr in peripheral IV site and 20 mEq/hr in central line

25
Q

What is used to treat mild to moderate hyperkalemia?

A

Sodium polystyrene sulfonate

26
Q

What is used to treat severe hyperkalemia?

A
  • dextrose with insulin
    • insulin, usually given with dextrose to prevent hypoglycemia, rapidly redistributes potassium into the cells and is considered first-line treatment for severe hyperkalemia
    • calcium gluconate
  • hemodialysis (in emergencies) to remove excess potassium

320 Pharmacology (36 decks)

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