Fluid Management Flashcards
What are the four categories of diuretics?
Loop: Ferosemide
Thiazide: HCTZ
Osmotic: Mannitol
Potassium-sparing: Aldosterone agents (spironolactone)
Patients are at risk of losing potassium with most diuretics except one. Which one?
Spironolactone
What is the use of Furosemide (Lasix)?
Rapid pr massive fluid mobilization
What is the MOA of Furosemide (Lasix)?
Blocks Na and H20 reabsorption form the thick segment of the loop of henle
What are the adverse effects of Furosemide?
Hyponatremia, Hypochloremia, and Dehydration
Hyperurecemia (gout)
Hypokalemia
Hyperglycemia
*Ototoxicity - if you give someone lasix really fast
What do you want to assess before administering Furosemide?
Weight
BP
HR
If a patient has these in the PMH they cannot be described this Furosemide
Gout Diabetes Mellitus Pregnant CVD Renal impairment
What do you want to evaluate for after administering Furosemide?
Fluid overload
Daily weights
I/O’s
Lung sounds
What is HCTZ used for?
Hypertension
Edema
What is the MOA of HCTZ?
Blocks Na and H20 reabsorption from the early segment of the distal convolutes tubule
When does HCTZ go into an effect?
2 hours after administration
What are some adverse effects of HCTZ?
Hyonatremia, Hypochloremia and Dehydration
Hypokalemia
Hyperglycemia
What do you want to assess before administering HCTZ?
Weight
BP
HR
Labs: k, Na, Cl
How long do the effects of HCTZ last?
12 hours
What is spironolactone used for?
Hypertension
Heart Failure
What is the MOA of spironolactone?
Blocks the actions of aldosterone in the distal nephron
How long does Spironolactone take to develop?
48 Hours
What do you want to assess in the MAR before administering Spironolactone?
Potassium supplements
No-Salt substitutes
ACE inhibitors
ARB’s
What is another name for Spironolactone?
Aldactone
Why should you double glove when handling Spironolactone?
It can cause reproductive harm to healthcare workers
What is the MOA of Mannitol?
Promotes diuresis by creating osmotic force within lumen of the nephron
What are the adverse effects of Mannitol?
Edema
Headache
Nausea
What are some examples of Hypotonic Fluids
0.25% NaCl
0.45% NaCl
5% D5W
What does a hypotonic solution do?
Shifts fluid out of vessels and into cells
What are some examples of Isotonic solutions?
0.9% NaCl
LR
What are some examples of Hypertonic solutions?
D5 0.45% NaCl
D5 0.9% NaCL
3% NaCl
What does a hypertonic solution do?
Shifts fluid back into circulation
What are the nursing considerations for hypotonic solutions?
May worsen hypotension
Can increase edema
What are the nursing considerations for Isotonic solution?
May cause fluid overload
What are the nursing considerations for hypertonic solutions?
May cause fluid overload
May cause hypernatremia and hyperchloremia
What is the purpose of Colloids?
helps fluid stay in the vasculature
