Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharm 1 > drug therapy for fluid volume excess > Flashcards

drug therapy for fluid volume excess Flashcards

(85 cards)

Start Studying
1
Q

what is anasarca

A

generalized severe edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is anuria

A

no urine output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is ascites

A

fluid build up in abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is edema

A

-swelling, excess build up of fluid in body tissue
-can be dependent (builds up in lowest point of body)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is extracellular fluid

A

-fluid outside of the cells
-build up may lead to edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is intracellular fluid

A

-fluid inside the cell
-circulates around

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the renal system composed of

A

-kidneys
-ureters
-bladder
-urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how much cardiac output do kidneys receive?

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

name some primary functions of the kidneys

A

-regulate volume
-composition of urine
-regulate pH
-eliminating wastes
-BP regulation
-RBC production (stimulate erythropoietin)
-vitamin D conversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

describe blood supply of the kidneys

A

-blood enters kidneys through the afferent arteriole (right off the aorta)
-blood leaves kidneys and goes back out to the body through the efferent arteiole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the renal capsule

A

fibrous tissue layer that protects kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the regions of the kidney and describe them just a little

A

-outer cortex (has nephrons)
-inner medulla (contains loop of henle)
-renal pelvis (takes urine and send it to the ureter)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

whats a nephron

A

-found in renal cortex
-functional unit of the kidney
-each kidney has about a million of these fuckers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

name three nephron functions

A

-glomerular filtration
-tubular secretions
-tubular reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

describe glomerular filration

A

-passage of components of blood and fluid through glomerulus
-filter out the good shit and send it back to the body (some Na+, K+, protein) and sends the rest of it to the ureter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

describe tubular secretions

A

active movement of substances from blood through renal tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

describe tubular reabsorption

A

movement of substances from renal tubule back to the vascular system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how does blood eneter the glomerulus

A

afferent arteriole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

is glomerular filtration a high or low pressure system?

A

high pressure (70mmHg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

describe the path of glomerular filtration

A

-high pressure system pushes water, electrolytes, and other solutes out
-then it goes to bowman’s capsule which catches stuff and weaves it to the proximal tubule
-proximal tubule is where the refinement of urine occurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is normal GFR? what happens if its low?

A

-125ml/min
-end product about 2L of urine/day
-decreased GFR = decreased UOP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how does blood leave the glomerulus?

A

efferent arteriole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

where is the loop of henle found?

A

nephron
rationale:the nephron is the functional unit of the kidney. each nephron contains a tubule and a glomerulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are some conditions that may require diuretic agents?

A

-alterations in renal function
-causal conditions:
cardiovascular
renal
hepatic
burns
trauma
allergies
inflammatory responses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
name three causes of edema and how would you treat them?
-increase capillary permeability -increased hydrostatic pressure -decreased plasma oncotic pressure tx: diuretic
26
describe increased capillary permeability
-part of response to tissue injury or allergic response -caps open up and let fluid flow from vessels to extravascular space, leading to swelling
27
describe increased hydrostatic pressure
-increased fluid volume and increased venous pressure -pushes fluid out of capillaries -seen with fluid overload
28
describe decreased plasma oncotic pressure
-result from low plasma proteins -lets fluid leak into external tissue
29
what are some clinical manifestations of fluid volume excess?
-edema (symptom of many disease processes) -alterations in fluid/electrolyte balance (kidneys control volume, composition, and pH of body fluids)
30
name some different types of edema
-dependent -pulmonary -anasarca ## Footnote diuretics can be used for all
31
# true or false? edema only occurs when the heart no longer functions efficiently
**false** *rationale:* edema is the exvessive accumulation of fluid in body tissues. it is the sx of many disease processes and may occur in any part of the body
32
what do diuretics do?
-increases renal secretion of water, sodium, and other electrolytes -increases urine formation and output
33
name some different diuretic classes
-**loop diuretics** (furosemide) -**thiazide/ thiazide-like diuretics** (HCTZ/metolazone) -**potassium sparing diuretics** (spironolactone) -**osmotic diuretics** (mannitol) -**carbonic anhydrase inhibitors** (acetazolamide)
34
drug selection and dosing with diuretics is dependent on...
-the patient's condition -is it acute or chronic?
35
which diuretic is preferred when rapid diuretic effect is necessary or when renal impairment is present?
loop diuretic
36
which diuretic may be used concurrently to prevent or manage hypokalemia?
potassium-sparing diuretic
37
name some examples of loop diuretics
-furosemide others: -bumetanide -torsemide
38
how can loop diuretics be administered
-PO -IV (fastest and strongest) -IM
39
describe the action of loop diuretics
-inhibit Na+/Cl- rebasorption -work in ascending loop of henle -**produce significant fluid loss**
40
what are some uses of loop diuretics
-**management of pulmonary edema, CHF, hepatic and renal disease** -given alone/combination for treatment of HTN -patients w renal impairment -patients w hepatic impairment -critically ill patients -home care pts
41
what are some adverse effects of loop diuretics
-fluid/electrolyte imbalances (hyponatremia, **hypokalemia**, **fluid volume deficit**) -ototoxicity (plasma drug levels >50 mcg/ml)
42
what is ototoxicity
-ringing in ears -can cause permanent hearing loss
43
what are some contraindications of loop diuretics
-anuria -allergy to sulfonamides
44
what are some drug-drug interactions with loop diuretics
-aminoglycosides, cephalosporins (increase diuretic effect) -**corticosteroids, digoxin** (increased risk of low potassium)
45
wha are some nursing implications of loop diuretics
-**slow push: 20mg/min** -check labs, especially Na+, K+, renal function -baseline weight and daily weight -accurate I and Os -closely monitor vitals, watch for hypotension -give PO in AM -monitor safety r/t dizziness
46
why would you give loop diuretics slow push?
to prevent ototoxicity
47
describe pt teaching for loop diuretics
-low sodium diet -high potassium diet -record daily weight -change position slowly -take in morning
48
give two examples of thiazide and thiazide like diuretics
-hydrochlorothiazide (HCTZ) -metolazone (thiazide like)
49
how are thiazide and thiazide like diuretics given
PO (not nearly as powerful as loop diuretics - good for at home maintenance)
50
describe the action of thiazide and thiazide like diuretics
decreases reabsorption of Na+, H2O, Cl-, HCO3 in distal convoluted tubule
51
describe the use of thiazide and thiazide like diuretics
-**first line of treatment for mild-moderate HTN** -edema associated CHF or nephrotic syndrome -patients with renal impairment
52
what are some adverse effects of thiazide and thiazide like diuretics
-**hypotension** -**dizziness** -**hypokalemia** -**hyperglycemia** -weakness -diarrhea/constipation
53
what are some contraindications of thiazide and thiazide like diuretics
-allergy to sulfonamides -renal failure/anuria
54
what are some nursing implications r/t thiazide and thiazide like diuretics
-check labs esp: Na, K, glucose, renal function -baseline weight and daily weight -accurate I & Os -closely monitor vitals, watch for hypotension -give in AM -monitor safety r/t dizziness
55
what are some important things to include with patient teaching for thiazide and thiazide like diuretics
-low sodium diet -high K diet -record daily weight -change position slowly -take in morning
56
describe the signs and symptoms of hypokalemia
-K below 3.5 -confusion -weakness -heart palpitations -GI upset can cause serious cardiac arryhtmias and death
57
describe the prevention of hypokalemia
-low dosing of diuretics -using supplemental potassium -use potassium sparing along with potassium losing medications -increase food intake of potassium -restrict dietary sodium intake
58
which assessment finding in a patient with heart failure receiving furosemide would indicate an improvement in fluid volume status? A) absence of crackles on auscultation of lungs B) complaints of nocturnal dyspnea C) bounding radial pulse D) decreased hematocrit
A) absence of crackles on auscultation of lungs *crackles usually indicate fluid in alveoli, hearing no crackles would indicate there is no excess fluid remaining in the lungs*
59
give an example of potassium-sparing diuretics
spironolactone
60
describe the pharmacokinetics of potassium-sparing diuretics
-slow onset and peak 24-48 hrs -6 weeks for maximum effect
61
describe the action of potassium-sparing diuretics
-blocks effects of aldosterone -weak diuretic effect -use in combination with other diuretics
62
describe the use of potassium-sparing diuretics
-**treatment of heart failure** -**ascites in liver disease** -hypokalemia -mild-moderate HTN -**hyperaldosteronism**
63
what are the adverse effects of potassium-sparing diuretics
-dizziness -diarrhea -**androgen like effects** (breast growth in males, irregular periods in females) -increase risk of GI bleed **black box warning: tumorigenic with chronic toxicity**
64
what are some contraindications of potassium-sparing diuretics
-renal insufficiency -hyperkalemia
65
what are some drug-drug interactions with potassium-sparing diuretics
-ACE-I -ARBs -K+ containing drugs
66
what are some nursing implications r/t potassium-sparing diuretics
-check labs esp: K+, renal function -baseline weight and daily weight -accurate I&Os -monitor safety r/t dizziness
67
describe patient teaching for potassium-sparing diuretics
-avoid salt substitutes -low k diet -record daily weight -monitor abd girth (liver disease) -change position slowly -take in morning with food
68
describe some signs and symptoms of hyperkalemia
-K+ greater than 5 -muscle cramps -EKG changes -hypotension -cardiac arrythmias can be fatal
69
describe the prevention of hyperkalemia
-potassium sparing along with potassium wasting meds -avoid potassium supplements -avoid salt substitutes -maintain urine output
70
give an example of osmotic diuretics
mannitol
71
describe how osmotic diuretics are given
IV - in glass bottle | usually in critical care areas
72
describe the action of osmotic diuretics
-increase solute load (osmotic pressure) of glomeruler filtrate -pulls from extravascular into blood -**decreases reabsorption of H2O and electrolytes**
73
what are some uses of osmotic diuretics
-**reduction of intracranial pressure** -**reduction of introcular pressure** -effective in decreased renal circulation and GFR
74
what are some adverse effects of osmotic diuretics
-**hypersmolar non-ketotic coma** -confusion -headache -syncope -**cardiac dysrhythmias** -**severe dehydration**
75
what are some contraindications of osmotic diuretics
-**severe dehydration** -abdominal pain -appendicitis -**pulmonary edema** -severe cardiac decompensation -older adults
76
what are some nursing implications for osmotic diuretics
-baseline physical exam, neuro, vitals -accurate I&Os -closely monitor vitals
77
what antidote is give if IV infiltrates with osmotic diuretics?
hyaluronidase
78
give an example of carbonic anhydrase inhibitors
acetazolamide
79
describe the pharmacokinetics of carbonic anhydrase inhibitors
given IV (like never tho) and eye gtt
80
describe the action of carbonic anhydrase inhibitors
inhibits carbonic anhydrase to reduce formation of aqueous humor and lower IOP
81
describe the use of carbonic anhydrase inhibitors
-open angle glaucoma -secondary glaucoma
82
what are some adverse effects of carbonic anhydrase inhibitors
-**metabolic acidosis** -stephen johnson syndrome -flaccid paralysis -blood dyscrasias
83
what are some contraindications of carbonic anhydrase inhibitors
-**chronic non-congestive agle-closure glaucoma** -renal/hepatic disease -addisons disease -electrolyte imbalance
84
what are some nursing implications r/t carbonic anhydrase inhibitors
-baseline vision exam -eye gtt administration
85
a nurse is instructing a pt on dietary considerations while takinf spironolactone. which of the following statements made by the pt indicates further teaching is necessary? A) I should not eat foods high is potassium while taking this med B) I should use salt substitutes instead of regular salt C) I should call the nurse practitioner if I have any adverse effects from my med D) I should not take potassium supplements
B) I should use salt substitutes instead of regular salt *most salt substitutes use potassium chloride as it tastes like salt. food high in potassium be avoided with spironolactone which is a potassium sparing diuretic*

Pharm 1 (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions