Lilley Chapter 29: Diuretic Drugs Flashcards
For a patient prescribed hydrochlorothiazide, the nurse should closely monitor which laboratory test value?
A. Glucose
B. Chloride
C. Sodium
D. Calcium
A. Glucose
Thiazide and thiazide-like diuretics are associated with adverse metabolic effects of hyperglycemia; therefore, close monitoring of blood glucose levels is needed. Other metabolic disturbances include hyperlipidemia and hyperuricemia.
The nurse is providing education to a patient prescribed spironolactone (Aldactone®) and furosemide (Lasix®). The nurse explains to the patient that
A. this combination maintains water balance to protect against dehydration and electrolyte imbalance.
B. this combination promotes diuresis but decreases the risk of low levels of potassium.
C. using two drugs increases blood osmolality and the glomerular filtration rate.
D. the lowest dose of two different types of diuretics are more effective than a large dose of one type.
B. this combination promotes diuresis but decreases the risk of low levels of potassium.
Spironolactone is a potassium-sparing diuretic; furosemide is a potassium-losing diuretic. Giving these together minimizes potassium loss.
Which laboratory test result is a common adverse effect of furosemide?
A. Hypophosphatemia
B. Hyperchloremia
C. Hypernatremia
D. Hypokalemia
D. Hypokalemia
Furosemide is a potent loop diuretic, and the most common adverse effect of loop diuretics is electrolyte imbalances. This results in major electrolyte losses of potassium and sodium and, to a lesser extent, calcium.
Why does the health care provider prescribe furosemide (Lasix) 40 mg twice a day by mouth for a patient with a history of renal insufficiency?
A. Furosemide has an antagonist effect to prevent respiratory alkalosis.
B. Furosemide is effective in treating patients with impaired kidney function.
C. Furosemide helps the kidney with reabsorption of sodium and water.
D. Furosemide is effective in treating patients with hypoaldosteronism.
B. Furosemide is effective in treating patients with impaired kidney function.
Furosemide effectiveness continues in impaired renal function. When creatinine clearance decreases below 25 mL/min (normal is 125 mL/min), the loop diuretics can still work.
The nurse would question the use of mannitol (Osmitrol®) for which condition in a patient?
A. Cerebral edema from head trauma
B. Oliguria from acute renal failure
C. Anuria related to end-stage kidney disease
D. Increased intraocular pressure
C. Anuria related to end-stage kidney disease
Mannitol does not influence urine production; it only increases existing urine output. It is not metabolized but is excreted unchanged in the urine by the kidneys. Thus, if no urine is produced (anuria), mannitol is not excreted, which increases blood volume. Excess blood volume may cause the undesirable adverse effect of pulmonary edema.
When preparing to administer intravenous furosemide (Lasix) to a patient with renal dysfunction, the nurse will administer the medication no faster than which rate?
A. 6 mg/min
B. 4 mg/min
C. 2 mg/min
D. 8 mg/min
B. 4 mg/min
The rate of furosemide-controlled infusion should not exceed 4 mg/min in patients with renal failure.
A patient asks the nurse about using potassium supplements while taking spironolactone (Aldactone®). What is the nurse’s best response?
A. “I would recommend that you take two multivitamins every day.”
B. “I will call your health care provider and discuss your concern.”
C. “You will need to take potassium supplements for the medication to be effective.”
D. “This diuretic is potassium sparing, so there is no need for extra potassium.”
D. “This diuretic is potassium sparing, so there is no need for extra potassium.”
Spironolactone is a potassium-sparing diuretic, and thus the patient does not need potassium supplementation. Intake of excess potassium may lead to hyperkalemia.
To treat a patient diagnosed with primary hyperaldosteronism, the nurse would expect to administer which diuretic?
A. spironolactone
B. hydrochlorothiazide
C. acetazolamide
D. furosemide
A. spironolactone
Spironolactone is the direct antagonist for aldosterone.
To treat a patient with pulmonary edema, the nurse prepares to administer which diuretic to this patient?
A. amiloride (Midamor®)
B. triamterene
C. spironolactone
D. furosemide
D. furosemide
Furosemide is a potent, rapid-acting diuretic that would be the drug of choice to treat pulmonary edema. The other medications are not potent enough to cause the diuresis necessary to treat this condition.
To evaluate the therapeutic effects of mannitol, the nurse should monitor the patient for which clinical finding?
A. Decrease in intracranial pressure
B. Decrease in serum osmolality
C. Increase in urine osmolality
D. Increase in cerebral blood volume
A. Decrease in intracranial pressure
Mannitol is an osmotic diuretic that pulls fluid from extravascular spaces into the bloodstream to be excreted in urine. This decreases intracranial pressure and cerebral blood volume, increases excretion of medications, decreases urine osmolality, and increases serum osmolality.
When assessing a patient taking triamterene, the nurse would monitor for which possible adverse effect?
A. Hypernatremia
B. Hyperkalemia
C. Hypoglycemia
D. Hypokalemia
B. Hyperkalemia
Triamterene is a potassium-sparing diuretic, and therefore hyperkalemia is a possible adverse effect.
When teaching a patient about symptoms of hypokalemia, the nurse will instruct the patient to notify the health care provider if which symptom occurs?
A. Muscle weakness
B. Diaphoresis
C. Blurred vision
D. Constipation
A. Muscle weakness
Muscle weakness is a common symptom of hypokalemia. The other answers are incorrect.
