Hypertension Diuretics Flashcards
Actions of a Diuretic
Diuretics, sometimes called water pills, help rid your body of salt (sodium) and water. Most of these medicines help your kidneys release more sodium into your urine. The sodium helps remove water from your blood, decreasing the amount of fluid flowing through your veins and arteries. This reduces blood pressure.
Specifics with LOOP
Loop diuretics are medications used in the management and treatment of fluid overload conditions such as heart failure, nephrotic syndrome or cirrhosis, and hypertension, in addition to edema.
POTASSIUM SPARING
Potassium-sparing diuretics are one type of diuretic. They are weak diuretics usually prescribed in combination with other types of diuretics. They are used to increase the amount of fluid passed from the body in urine, whilst also preventing too much potassium being lost with it
Potassium Sparing Use
They are typically used as an adjunct in management of hypertension, cirrhosis, and congestive heart failure.
Potassium Sparing Medications
- Amiloride (Midamor)
* Triamterene (Dyrenium) - Spirolactones (Aldactone, Carospir)
- Eplerenone (Inspra)
Potassium Sparing Adverse reactions
Hyperkalemia (increased levels of potassium in the blood)
Nausea and vomiting.
Abdominal discomfort.
Headache.
Drowsiness.
Confusion.
Ataxia (loss of control on bodily movements due to lack of coordination between muscles and brain)
Kidney stones.
Low potassium (hypokalemia) refers to a lower than normal potassium level in your bloodstream. Potassium helps carry electrical signals to cells in your body.
HYPOKALEMIA
High potassium (called “hyperkalemia”) is a medical problem in which you have too much potassium in your blood.
HYPERKALEMIA
is an increase in the amount of breast gland tissue in boys or men, caused by an imbalance of the hormones estrogen and testosterone.
GYNECOMASTIA
Therapy can prevent additional clots from forming.
*group of drugs included warfarin and fractionated and unfractionated heparin
Anticoagulants
glycosides (used to treat heart failure)
*concurrently require frequent monitoring of the pulse rate and rhythm because of the possibility of cardiac arrhythmias
DIGITALIS
Insulin or oral antidiabetic drug dosages may require alterations because of hyperglycemia; therefore serum glucose concentrations are monitored periodically.
K sparing:
Antidiabetic drugs
Patients with Edema
Accumulation of excess water in the body
Many conditions or diseases, such as heart failure (HF), endocrine disturbances, and kidney and liver diseases, can cause fluid overload or edema.
Clinician may prescribe a diuretic to reduce the increased fluid
Clients with edema caused by HF or other conditions are weighed daily or as ordered by the health care provider.
Parenteral loop diuretics are typically used in the hospital for rapid fluid loss when it interferes with cardiac function. Weight loss of about (2 lbs) daily is desirable to manage fluid loss and prevent dehydration and electrolyte imbalance.
Every 8 hours, carefully measure and document the fluid intake and output. The critically ill client with renal disease may require more frequent measurements of urinary output.
The blood pressure, pulse, and respiratory rate are assessed every 4 hours or as ordered by the clinician. An acutely ill client may require more frequent monitoring of the vital signs.
Areas of edema are examined daily to evaluate the effectiveness of drug therapy. Note the client’s general appearance and condition daily or more often if the client is acutely ill.
Patients with HTN
Teach the hypertensive client how to monitor their blood pressure and pulse rate when receiving a diuretic or a diuretic along with an antihypertensive drug.
Clients can monitor their own vital signs easily when going to the grocery store or pharmacy; many of these places have access for free monitoring.
For those who wish to use technology, many devices will monitor pulse and blood pressure, as well as activity.
Vital signs, including respiratory rate, are more frequently monitored when the client is critically ill or the blood pressure is excessively high
Renal Compromise
When thiazide diuretics are administered, renal function should be monitored periodically. These drugs may cause azotemia (accumulation of nitrogenous waste in the blood). If nonprotein nitrogen (NPN) or (BUN) levels increases, the clinician may consider withholding the drug or discontinuing its use.
In addition, serum uric acid concentrations are monitored periodically during treatment with thiazide diuretics because these drugs may cause an acute attack of gout; therefore be alert to client complaints of joint pain or discomfort.
Insulin or oral antidiabetic drug dosages may require alterations because of hyperglycemia; therefore serum glucose concentrations are monitored periodically.
Electrolyte Imbalances
As fluid electrolytes shift in the body be alert for imbalances. One of the primary and balances to monitor is potassium. Clients who experience cardiac arrhythmias or who are being “digitalized” (initiating digoxin therapy) may be more susceptible to significant potassium loss when taking diuretics. The potassium-sparing diuretics are recommended for these clients.
When would a nurse administer a diuretic
Hypertension
Edema
Renal disease
Cerebral Edema
Seizures and altitude sickness
Impaired Urinary elimination
It’s good to explain to the client that eliminating fluids helps the heart and blood work efficiently.
Risk for FVD
Monitor the fluid intake and output so the client doesn’t become dehydrated.
List food sources for Potassium replacement
Fruits (10 highest): apricots, prunes, dried currants/raisins, dates, figs, dried coconut, avocado, bananas, oranges, nectarines, and peaches.
Vegetables (10 highest): sun-dried tomatoes, spinach, Swiss chard, mushrooms, sweet potato, kale, brussels sprouts, zucchini, green beans, and asparagus.
Other sources: chocolate, molasses, nuts, and nut butters
