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Pharmacology > Fluid and Electrolyte Balance: Part 2 > Flashcards

Fluid and Electrolyte Balance: Part 2 Flashcards

1
Q

Potassium sparing diuretics

A

Increase urine production and decrease K+ excretion

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2
Q

Potassium sparing diuretics block…

A

Aldosterone action in distal nephron to increase K+ retention and excretion of Na+

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3
Q

What is the only approved potassium-sparing diuretic in the US?

A

Spironolactone (Aldactone)

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4
Q

Spironolactone onset of action

A

May take up to 48 hours to produce effects

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5
Q

Potassium-sparing diuretics therapeutic uses

A

In combination with loop or thiazide diuretics for hypertension and edema for heart failure
Hyperaldosteronism

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6
Q

PSDs are rarely given IV because…

A

They do not work fast enough

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7
Q

What is one way you would know a person is hypokalemic?

A

Cramps

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8
Q

Adverse effects of PSDs

A

Hyperkalemia
N/V
Leg cramps

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9
Q

Drug interactions with PSDs

A

Never give with drugs that increase K+ (ACE inhibitors)

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10
Q

Osmotic diuretics main medication

A

Mannitol (Osmitrol)

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11
Q

Mannitol IV action in..

A

30-80 min; lasts 8 hours

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12
Q

Mannitol therapeutic doses

A

Renal failure prophylaxis
Reduction of intracranial pressure
Reduction of intraocular pressure

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13
Q

Adverse effects of osmotic diuretics

A

Can leave vascular system except in brain

Caution with heart disease, HA, N/V, F/E imbalance

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14
Q

Osmotic diuretics are only used…

A

In critical care setting, short term, usually only a couple days

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15
Q

How do osmotic diuretics work?

A

Create an osmotic gradient > makes blood hyperosmolar > pulls fluid into the blood

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16
Q

What happens if too much osmotic is given?

A

Will pull from the brain and start 3rd spacing everywhere (lungs, ascites)

17
Q

Osmotic dose based on..

A

ICP

18
Q

Osmotic diuretics reduction of intraocular pressure

A

When patient gets strongly hit in head, it can change angle of aqueous humor

19
Q

Angle closure glaucoma

A

Needs to be treated immediately in order to avoid blindness, needs surgery

20
Q

Renal failure prophylaxis

A

Emergency situation, continues to force kidneys to make a small amount of urine because of osmotic shifts - last stitch effort to keep kidneys going a little longer

21
Q

IV fluids are ordered based on…

A

Fluid & Electrolyte balance
FLuid requirements
Fluid volume deficit

22
Q

Type of IV solutions

A

Crystalloids
Colloids
Blood & Blood products

23
Q

Crystalloids

A

Clear solutions that contain fluid & electrolytes

Feely cross capillary walls

24
Q

Crystalloids treat…

A

Dehydration
Electrolyte imbalances
Short-term maintenance fluids
Early plasma expansion (shorter duration of action)

25
Q

What type of crystalloid solution would be given for edema?

A

Hypertonic to decrease fluid in tissues

26
Q

Examples of isotonic fluids

A

LR- lactated ringers
0.9% NaCl
D5W 5% dextrose in water

27
Q

If you add anything to isotonic fluids, you make them _______ and if you take anything away you make them _________

A

Hypertonic

Hypotonic

28
Q

If a person is hemorrhaging, can you give them crystalloids?

A

Yes for a short time to keep them perfusing and oxygenated until you can get blood and colloids
(keep them from going into hypovolemic shock)

29
Q

Hypertonic solution

A

> 300
Decreases ICP and severe hyponatremia
Can cause fluid overload
Not for CHF patients

30
Q

Isotonic

A

280-300mOsm
Corrects dehydration and sodium depletion
Caution with cardiac / renal disease
Do NOT use in patients with increased ICP

31
Q

Hypotonic

A

<280
Replaces cellular fluid (Diabetes ketoacidosis)
Do not use with shock patients, trauma, burns (risk of depleting vascular volume)

32
Q

Colloids

A

Solutions that contain proteins or other large molecules

33
Q

What do colloids do?

A

Increase osmolarity without dissolving in solution

34
Q

Colloids are plasma ______

A

Expanders (Pull fluids from the interstitial space into the plasma)

35
Q

Color of colloids

A

Pale yellow or brownish

36
Q

When giving IV solutions, what order do you go in?

A

Crystalloids, colloids then blood products

Pharmacology (38 decks)

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