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Pharm > GU, Diuretics, Fluid + Electrolytes > Flashcards

GU, Diuretics, Fluid + Electrolytes Flashcards

1
Q

Drug card:
Oxybutynin

A
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2
Q

Drug card:
Hydrochlorithiazide (HCTZ/)

A
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3
Q

Drug card:
Furosemide

A
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4
Q

Drug card:
Spironolactone

A
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5
Q

Drug card:
Mannitol

A
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6
Q

Drug card:
Potassium

A
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7
Q

Utilize the nursing process to provide safe and effective medication admin of diuretics and potassium replacements:

A
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8
Q

Review renal functions:
Maintenance of volume and composition of body fluids

A

Sodium regulation

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9
Q

Review renal function:
BP control

A

RAAS system

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10
Q

What is the mechanism of action and the indications for diuretics?

A

MOA:
Acts on kidneys to increase urine output

Indications:
— HTN
— fluid overload
— edema
— HF
— pulm edema
— kidney/liver failure
— hyperkalemia (removes excess K)

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11
Q

What are the general adverse affects of diuretics?

A

— GI upset: n/v/d
— hypotension
— dehydration
— fluid and electrolyte disturbances: sodium + potassium
— fluid rebound

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12
Q

What is fluid rebound?

A

Rebound edema; fluid is retained

Happens with patients on diuretics that do not drink enough water
— plasma becomes more concentrated; less water in the bloodstream
— decreased volume sensed by kidneys: RAAS
— increases vascular volume; ADH is released

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13
Q

What are general contraindications with diuretics?

A

— hypotension
— dehydration
*these are AE, we are not going to give diuretics if patient is already experiencing
AE
— renal failure: will not work as well; diuretics can worsen renal failure
— pregnancy/lactation

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14
Q

What are drug-drug interactions with diuretics?

A

-Digoxin: increases potassium loss
-Anticoagulants, anti diabetic drugs: recudes effectiveness
-Lithium: increased risk of toxicity (sodium)

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15
Q

Assessment and monitoring:

A

— allergies
— contraindictations
— kidney function
— VS: hypotension (poor infusion)
— rapid weight gain or loss (fluid balance)
— I&O (fluid overload/dehydration

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16
Q

Labs to monitor with patients on diuretics

A

— decreased potassium
— decreased sodium
— increased serum uric acid (decreased excretion)
— increased BG
— DECREASED KIDNEY FUNCTION

17
Q

Why is there a risk for increased BG with diuretics?

A

Change in potassium keeps glucose out of cells

18
Q

Teaching:

A

— daily weights
— monitor for hypotension
— potassium supplements
— maintain fluid intake
— monitor for aggravating factors of fluid loss: diarrhea, vomiting
— report fluid imbalance
— TAKE DIURETICS IN AM
— CHANGE POSITION SLOWLY

19
Q

Which assessment should the nurse prioritize prior to the admin of a diuretic?

A. BP
B. Weight
C. Lung sounds
D. Renal function

A

A. BP

Nurse must take BP prior to admin due to fluid loss (hypotension)

20
Q

Which diuretics may cause hypokalemia? SATA

A. Mannitol
B. Spironolactone
C. Furosemide
D. Hydrochlorothiazide

A

A, C, D

Spironolactone works by blocking aldosterone, thus causing an increase in potassium

21
Q

The med-surg nurse is planning care for a client taking furosemide who was admitted with acute CHF. The nurse should plan for which expected outcome?

A. Potassium level will decrease to 3.2
B. Weight will decrease by 9 lbs in 2 days
C. Urinary output will be 500 mL per day
D. BP will be 95/65

A

B

The client needs to excrete excess fluid to decrease the workload of the heart. Weight loss will occur with fluid loss which is one way to assess the effectiveness of the medication

22
Q

Osmolarity

A

Concentration of a fluid

Sodium, glucose, urea

23
Q

Tonicity

A

Ability of solution to cause change in water movement across membranes due to osmosis

24
Q

Isotonic

A

Same concentration of particles of plasma

— stays on intravascular space
— no movement of water; no change in osmolarity

25
Q

Hypertonic

A

Greater concentration than the plasma

— water will move out of cells into solution
CELLS WILL SHRINK

26
Q

Hypotonic

A

Lesser concentration than plasma

Fluid comes from extra cellular compartments INTO cells

CELLS SWELL

27
Q

Hemoglobin + hematocrit labs

A

Increase: fluid volume deficit (dehydration)
Decrease: fluid overload (dilution); MASSIVE BLOOD LOSS

28
Q

BUN

A

8-20

Increase: dehydration
Decrease: fluid overload

29
Q

Creatinine

A

0.6-1.2

Increase: renal failure

30
Q

Specific gravity

A

1.010-1.025

Concentration of urine
Increase: dehydration
Decrease: fluid overload

31
Q

What are crystalloids?

A

IV solutions with electrolytes

Isotonic: NS 0.9% (NaCl)
Hypertonic: 10% dextrose (D10W) 3% NaCl
Hypotonic: 0.45% NaCl (1/2 strength saline)

32
Q

What are colloids?

34
Q

Potassium administration

Pharm (16 decks)

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