Loop Diuretics Flashcards
Where do loop diuretics work?
on the loop of henle in the nephron, specifically the thick ascending limb
With diuretics, what is the goal?
the goal is to increase urinary output by limiting how parts of the nephron reabsorb sodium
Hence, if we don’t reabsorb much sodium back into the blood, it will stay in the filtrate within the nephron, and this will keep more water in the filtrate too…hence increasing urine production.
______________ are the most powerful of all the types of diuretics when compared to thiazides and potassium-sparing diuretics.
Loops diuretics
Loop diuretics tend to end in
mide or nide
Furosemide
Torsemide
Bumetanide
Ethacrynic Acid is the exception
Loop diuretics inhibit what in the thick ascending Loop of Henle ?
The sodium potassium chloride cotransporter
- this transports specific ions from the filtrate back into the blood. If we inhibit this ion transport, specifically sodium, it will alter tonicity, affecting the movement of water. More water will stay in filtrate
what is the functional unit of the kidney ?
The nephron - there are millions of these units with the kidneys
the renal cortex is an _____________ environment
isotonic
the renal medulla is a ____________ environment
hypertonic
Each part of the nephron has its own unique role for _______ the filtrate that is created by the glomerulus.
tweaking
What is the name of the vessel that takes blood from the renal artery and delivers it to the nephron
afferent arteriole
what is the name of the vessel that takes filtered blood and sends it back to the body?
Efferent arteriole
what to remember about the descending loop of Henle?
It is permeable to water but not to ions. Water can leave the descending limb and concentrate the filtrate
the thick ascending loop of Henle is permeable to ______ but not to __________
ions; water
What are loop diuretics used for ?
heart failure Liver impairment (ascites) Pulmonary edema Hypertension Hypercalcemia
With patients taking loop diuretics, they are at a big risk for __________
dehydration
- vitals (s/s dehydration)
- Strict I & O’s
- Daily Weights (same time & same scale)
weighing the patient is a great indicator of their fluid volume status. True or false.
TRUe
Do loop diuretics have the potential to increase or decrease potassium levels ?
Decrease- there is a risk for hypokalemia
If patient is on Digoxin and taking a loop diuretic, you always want to monitor which lab value?
Potassium level - because low potassium levels can increase digoxin toxicity
Aldosterone will cause the body to keep sodium and excrete potassium. True or false.
True
What labs can be decreased and/or elevated by Loop diuretics?
decreased potassium, calcium, magnesium and sodium (If the patient is taking Lithium, monitor for Lithium toxicity because low sodium levels in the blood can increase Lithium toxicity)
Increased uric acid levels (monitor for signs of gout)
Loop diuretics can cause inner ear damage, which is called ………….._________________________. Therefore we should give them _________________ through IV administration
ototoxicity; slowly
To check effectiveness of loop diuretics, what should we assess
look at weights
see how much urine they are putting out
listen to lungs - do you hear crackles if there is fluid in there
check for dependent edema
Education for patients on loop diuretics
Teach them to watch out for signs of dehydration -
and measure BP at home
Healthy diet with foods rich in potassium
Change positions slowly because we are changing the fluid volume status within the patient
Weigh self daily and record it (contact their doctor if they gain 3 lbs or more in 1 day…this could mean they’re retaining fluid)
Ethacrynic acid has a greater potential to cause _______________ than Furosemide
ototoxicity
