Fluid Management

Question 1

What are the four categories of diuretics?

Answer 1

Loop: Ferosemide
Thiazide: HCTZ
Osmotic: Mannitol
Potassium-sparing: Aldosterone agents (spironolactone)

Question 2

Patients are at risk of losing potassium with most diuretics except one. Which one?

Answer 2

Spironolactone

Question 3

What is the use of Furosemide (Lasix)?

Answer 3

Rapid pr massive fluid mobilization

Question 4

What is the MOA of Furosemide (Lasix)?

Answer 4

Blocks Na and H20 reabsorption form the thick segment of the loop of henle

Question 5

What are the adverse effects of Furosemide?

Answer 5

Hyponatremia, Hypochloremia, and Dehydration
Hyperurecemia (gout)
Hypokalemia
Hyperglycemia

*Ototoxicity - if you give someone lasix really fast

Question 6

What do you want to assess before administering Furosemide?

Answer 6

Weight
BP
HR

Question 7

If a patient has these in the PMH they cannot be described this Furosemide

Answer 7

Gout
Diabetes Mellitus
Pregnant
CVD
Renal impairment

Question 8

What do you want to evaluate for after administering Furosemide?

Answer 8

Fluid overload
Daily weights
I/O’s
Lung sounds

Question 9

What is HCTZ used for?

Answer 9

Hypertension

Edema

Question 10

What is the MOA of HCTZ?

Answer 10

Blocks Na and H20 reabsorption from the early segment of the distal convolutes tubule

Question 11

When does HCTZ go into an effect?

Answer 11

2 hours after administration

Question 12

What are some adverse effects of HCTZ?

Answer 12

Hyonatremia, Hypochloremia and Dehydration
Hypokalemia
Hyperglycemia

Question 13

What do you want to assess before administering HCTZ?

Answer 13

Weight
BP
HR
Labs: k, Na, Cl

Question 14

How long do the effects of HCTZ last?

Answer 14

12 hours

Question 15

What is spironolactone used for?

Answer 15

Hypertension

Heart Failure

Question 16

What is the MOA of spironolactone?

Answer 16

Blocks the actions of aldosterone in the distal nephron

Question 17

How long does Spironolactone take to develop?

Answer 17

48 Hours

Question 18

What do you want to assess in the MAR before administering Spironolactone?

Answer 18

Potassium supplements
No-Salt substitutes
ACE inhibitors
ARB’s

Question 19

What is another name for Spironolactone?

Answer 19

Aldactone

Question 20

Why should you double glove when handling Spironolactone?

Answer 20

It can cause reproductive harm to healthcare workers

Question 21

What is the MOA of Mannitol?

Answer 21

Promotes diuresis by creating osmotic force within lumen of the nephron

Question 22

What are the adverse effects of Mannitol?

Answer 22

Edema
Headache
Nausea

Question 23

What are some examples of Hypotonic Fluids

Answer 23

0.25% NaCl
0.45% NaCl
5% D5W

Question 24

What does a hypotonic solution do?

Answer 24

Shifts fluid out of vessels and into cells

Question 25

What are some examples of Isotonic solutions?

Answer 25

0.9% NaCl

LR

Question 26

What are some examples of Hypertonic solutions?

Answer 26

D5 0.45% NaCl
D5 0.9% NaCL
3% NaCl

Question 27

What does a hypertonic solution do?

Answer 27

Shifts fluid back into circulation

Question 28

What are the nursing considerations for hypotonic solutions?

Answer 28

May worsen hypotension

Can increase edema

Question 29

What are the nursing considerations for Isotonic solution?

Answer 29

May cause fluid overload

Question 30

What are the nursing considerations for hypertonic solutions?

Answer 30

May cause fluid overload

May cause hypernatremia and hyperchloremia

Question 31

What is the purpose of Colloids?

Answer 31

helps fluid stay in the vasculature