Surg 126--Chapter 7

Question 1

Medications administered to prevent reabsorption of sodium and water by the kidneys?

Answer 1

Diuretics

Question 2

Diuretics are used in the management of several chronic medical conditions, such as…

Answer 2

Hypertension, congestive heart failure (CHF), and glaucoma

Question 3

What are electrolytes?

Answer 3

• Minerals that are dissolved in body fluids
• Develop an electrical charge when dissolved in water
• Found inside and outside of cells
• Acquired through food and water

Question 4

What are the major body electrolytes?

Answer 4

• Sodium
• Potassium
• Calcium
• Chlorine
• Magnesium
• Bicarbonate
• Phosphate
• Sulfate

Question 5

Condition in which potassium may be seriously depleted in patients taking certain diuretics.

Answer 5

Hypokalemia

Question 6

Potassium levels that are either too low or too high may cause…

Answer 6

Cardiac dysrhythmias

Question 7

Short-term use of diuretics is indicated when?

Answer 7

A condition requires rapid but temporary reduction in fluid

Question 8

Why are diuretics used during surgery?

Answer 8

To reduce intraocular pressure, intracranial pressure, or to protect kidney function

Question 9

How do diuretics lower blood pressure?

Answer 9

By increasing the elimination of fluids (water, sodium, and electrolytes) from the body; decreasing blood volume

Question 10

Are diuretics administered from the back table?

Answer 10

No

Question 11

Why are diuretics important to the ST?

Answer 11

• Long-term diuretic therapy may cause the delay or rescheduling of a surgery.
• Short-term intraoperative use of diuretics requires the insertion of an indwelling urinary catheter

Question 12

The primary function of the renal system is to _____?

Answer 12

maintain homeostasis

Question 13

How does the renal system maintain homeostasis?

Answer 13

By filtering blood and removing excess water and dissolved substances (or solutes) such as sodium and potassium

Question 14

A microscopic filtering unit that removes water and waste solutes

Answer 14

nephron

Question 15

Where does filtration occur in the nephron?

Answer 15

The Bowman’s capsule

Question 16

The process of forcing fluids and solutes through a membrane by pressure.

Answer 16

filtration

Question 17

Where does tubular reabsorption take place?

Answer 17

proximal convoluted tubule and the ascending and descending limbs of the loop of Henle

Question 18

Eliminates waste products and controls blood pH.

Answer 18

tubular secretion

Question 19

Diuretics cause elimination of excess fluid by preventing reabsorption of _____ and _____, increasing urine output.

Answer 19

sodium and water

Question 20

How are diuretics classified?

Answer 20

• site of action

- mechanism by which the solute is altered

Question 21

Highly potent diuretics used to remove fluid arising from renal, hepatic, or cardiac dysfunction and to treat acute pulmonary edema.

Answer 21

Loop diuretics

Question 22

Loop diuretics inhibit the reabsorption of _____ to _____ of the sodium load.

Answer 22

20% to 30%

Question 23

What is the most common cardiac dysfunction requiring treatment with diuretics?

Answer 23

CHF

Question 24

The oral form of high-ceiling diuretics may be used to treat _____.

Answer 24

hypertension

Question 25

Loop diuretics work by decreasing the reabsorption of _____ and _____ ions along the whole renal tubule, especially the loop of Henle.

Answer 25

sodium and chloride

Question 26

Loop diuretics include:

Answer 26

- bumetanide (Bumex) - ethacrynic acid (Edecrin) - torsemide (Demadex) - furosemide (Lasix)

Question 27

What is the most commonly used loop diuretic?

Answer 27

furosemide

Question 28

Furosemide:

Answer 28

- useful in intracranial procedures - onset of diuresis in 5 to 15 minutes, will continue for 2 hours - initial dose is 20 to 40 mg, given over 1 to 2 minutes - second dose may be administered 2 hours later

Question 29

Furosemide decreases intracranial pressure by quickly removing _____ that accumulates in response to trauma of the cranium

Answer 29

fluids

Question 30

Low potency diuretics used to treat essential hypertension and mild chronic edema.

Answer 30

Thiazide diuretics

Question 31

Thiazide diuretics inhibit the reabsorption of _____ to ______ of the sodium load.

Answer 31

5% to 10%

Question 32

Thiazide diuretics work by inhibiting the reabsorption of sodium and chloride in the end of the _____ of the nephron and the beginning of the _____.

Answer 32

ascending loop | distal convoluted tubule

Question 33

Examples of thiazide diuretics:

Answer 33

- bendroflumethiazide (Naturetin) - chlorothiazide (Diuril, SK-Chlorothiazide) - hydrochlorothiazide

Question 34

Low potency diuretics commonly used to treat edema and hypertension and to help restore potassium levels in hypokalemic patients.

Answer 34

Potassium-sparring drugs

Question 35

Potassium-sparring diuretics inhibit only _____ to _____ of the sodium load.

Answer 35

1% to 3%

Question 36

Usually administered in combination with other diuretics such as thiazides and loop diuretics to minimize potassium loss.

Answer 36

Potassium-sparring drugs

Question 37

Potassium-sparring drugs prevent the reabsorption of sodium in the _____ by altering membrane permeability.

Answer 37

distal convoluted tubule

Question 38

Examples of potassium-sparring drugs include:

Answer 38

- amiloride (Midamor) - spironolactone (Aldactone) - eplerenone (Inspra) - triamterene (Dyrenium)

Question 39

Adverse effects of potassium-sparring drugs includes _____.

Answer 39

hyperkalemia

Question 40

Low potency diuretics used to treat mild acute closed-angle glaucoma and chronic open-angle glaucoma and lowers intraocular pressure.

Answer 40

Carbonic anhydrase inhibitors

Question 41

Carbonic anhydrase inhibitors act on the _____, so urine output is not significantly changed.

Answer 41

proximal convoluted tubule

Question 42

The most common carbonic anhydrase inhibitors

Answer 42

acetazolamide (Diamox)

Question 43

Highly potent and increase blood pressure and volume by drawing fluid out of tissues and into the circulatory system rapidly.

Answer 43

Osmotic diuretics

Question 44

Contraindicated in patients with hypertension and edema.

Answer 44

Osmotic diuretics

Question 45

The most common osmotic diuretic

Answer 45

mannitol (Osmitrol)

Question 46

May be used to provide rapid reduction in intraocular pressure in patients experiencing acute angle-closure glaucoma

Answer 46

mannitol (Osmitrol)

Question 47

Cause the highest rate of potassium loss.

Answer 47

thiazide and loop diuretics

Question 48

One of the essential minerals needed by the body to maintain homeostasis.

Answer 48

potassium

Question 49

One of the most abundant minerals found in the body.

Answer 49

potassium

Question 50

Normal level of potassium

Answer 50

3.5 to 5.0

Question 51

Best method for treatment of hypokalemia

Answer 51

oral replacement

Question 52

mineralocorticoid hormone produced by the adrenal cortex

Answer 52

aldosterone

Question 53

Increases the reabsorption of sodium and water and the secretion of potassium in the kidneys.

Answer 53

aldosterone

Question 54

Increases blood volume and thus blood pressure

Answer 54

aldosterone

Question 55

Primary intracellular electrolyte in the body

Answer 55

potassium

Question 56

plats a vital role in many body functions, such as nerve impulse conduction, acid-base balance, ad promotion of carbohydrate and protein metabolism

Answer 56

potassium