Loop Diuretics

Question 1

Where do loop diuretics work?

Answer 1

on the loop of henle in the nephron, specifically the thick ascending limb

Question 2

With diuretics, what is the goal?

Answer 2

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.

Question 3

______________ are the most powerful of all the types of diuretics when compared to thiazides and potassium-sparing diuretics.

Answer 3

Loops diuretics

Question 4

Loop diuretics tend to end in

Answer 4

mide or nide

Furosemide
Torsemide
Bumetanide

Ethacrynic Acid is the exception

Question 5

Loop diuretics inhibit what in the thick ascending Loop of Henle ?

Answer 5

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

Question 6

what is the functional unit of the kidney ?

Answer 6

The nephron - there are millions of these units with the kidneys

Question 7

the renal cortex is an _____________ environment

Answer 7

isotonic

Question 8

the renal medulla is a ____________ environment

Answer 8

hypertonic

Question 9

Each part of the nephron has its own unique role for _______ the filtrate that is created by the glomerulus.

Answer 9

tweaking

Question 10

What is the name of the vessel that takes blood from the renal artery and delivers it to the nephron

Answer 10

afferent arteriole

Question 11

what is the name of the vessel that takes filtered blood and sends it back to the body?

Answer 11

Efferent arteriole

Question 12

what to remember about the descending loop of Henle?

Answer 12

It is permeable to water but not to ions. Water can leave the descending limb and concentrate the filtrate

Question 13

the thick ascending loop of Henle is permeable to ______ but not to __________

Answer 13

ions; water

Question 14

What are loop diuretics used for ?

Answer 14

heart failure 
Liver impairment (ascites)
Pulmonary edema 
Hypertension 
Hypercalcemia

Question 15

With patients taking loop diuretics, they are at a big risk for __________

Answer 15

dehydration

• vitals (s/s dehydration)
• Strict I & O’s
• Daily Weights (same time & same scale)

Question 16

weighing the patient is a great indicator of their fluid volume status. True or false.

Answer 16

TRUe

Question 17

Do loop diuretics have the potential to increase or decrease potassium levels ?

Answer 17

Decrease- there is a risk for hypokalemia

Question 18

If patient is on Digoxin and taking a loop diuretic, you always want to monitor which lab value?

Answer 18

Potassium level - because low potassium levels can increase digoxin toxicity

Question 19

Aldosterone will cause the body to keep sodium and excrete potassium. True or false.

Answer 19

True

Question 20

What labs can be decreased and/or elevated by Loop diuretics?

Answer 20

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)

Question 21

Loop diuretics can cause inner ear damage, which is called ………….._________________________. Therefore we should give them _________________ through IV administration

Answer 21

ototoxicity; slowly

Question 22

To check effectiveness of loop diuretics, what should we assess

Answer 22

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

Question 23

Education for patients on loop diuretics

Answer 23

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)

Question 24

Ethacrynic acid has a greater potential to cause _______________ than Furosemide

Answer 24

ototoxicity