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Flashcards in Ch 19 Urinary Output Deck (25)
0

High ceiling loop diuretics

Prototype: furosemide (Lasix)

Other drugs: Ethacrynic ( Edecrin)
Bumetanide ( Bumex)
Torsemide ( Demadex)

1

What is the expected pharmalogical action of loop diuretics

They work in the ascending loop of henle
Blocks reabsorption of sodium and chloride to prevent reabsorption of water.
Causes extensive diuresis even with severe renal impairment

2

What are the therapeutic uses of loop diuretics

They are used when there is need for the rapid administration of fluid
They are used for pulmonary edema caused by HF
They are used in conditions not responsive to other diuretics, such as edema caused by liver, cardiac, or kidney disease or HTN

THESE MEDS MAY ALSO BE USED TO TREAT HYPERCALCEMIA R/T KINDNEY STONE FORMATION

3

What are adverse effects of loop diuretics

Dehydration
Hyponatremia
Hypochloremia
Hypotension
Hypokalemia
Decrease in calcium and magnesium levels
Ototoxicity ( transient with furosemide and irreversible with Ethacrynic acid)

4

What are high potassium foods

Bananas, potatoes, Dried fruits, nuts, spinach, citrus fruit

5

What are signs of hypokalemia

Nausea/ vomiting
General weakness

6

What is a medication interaction of loop diuretics

Digoxin
Ventricular dysrhythmias can occur in the presence of HYPOKALEMIA
Concurrent use with antihypertensives can cause additive hypotensive effect.
Lithium serum levels can be increased which leads to toxicity
NSAIDS decrease blood flow to kidneys which reduces the diuretic effect

7

What are signs of low magnesium

Weakness
Muscle twitching

8

How can a nurse recognize that the loop diuretics worked

Decrease in pulmonary or peripheral edema
Weight loss
Decrease in BP
increase in urinary output

9

Thiazide diuretics select prototype drug

Hydrochlorothiazide ( Hydrodiuril)

Other drugs; chlorothiazide ( Diuril)
methyclothiazide ( Enduron)

Thiazides type diuretics-
Indapamidem( Lozide, Lozol)
Chlorthalidone ( Hygroton)
Metolazone ( Zaroxolyn)

10

How do Thorazine diuretics work

They work in the early distal convoluted tubule
Blocks the reabsorption of sodium and chloride, and prevents the reabsorption of water at this site
Promotes diuresis when renal function is not impaired

They are often the 1st med of choice for essential HTN
these meds may be used for edema to mild to moderate HF and liver and kidney disease.

11

What are adverse effects of thiazides diuretics

Dehydration
Hypokalemia
Hyperglycemia

12

What are pre assessments of the drug thiazides diuretics

Obtain clients baseline data including
Orthostatic BP
weight
Electrolytes
And location and extent of edema

13

Potassium sparing diuretics

Prototype drug; spironolactone ( Aldactone)

Other drugs; triamterene ( Dyrenium) amiloride ( Midamor)

14

What is the expected pharmalogical action of potassium sparing diuretics

Blocks the action of aldosterone ( sodium and water rentention) which results in potassium rentention and the excretion of sodium and water

15

What are the therapeutic uses of potassium sparing diuretics

Oral administration
Used for HF
May take 12-48 hours for effect

16

What are the side effects of potassium sparing diuretics

Hyperkalemia
Endocrine effects..impotence in men, irregularities in menstrual cycle for woman.

17

What are med interactions of potassium sparing diuretics

ACE INHIBITORS increase the risk of hyperkalemia

18

Triamterene may turn the urine what color

A bluish color

19

What are osmotic diuretics

Osmotic diuretics reduce intracranial pressure and intraocular pressure by raising serum osmolality and drawing fluid back into the vascular and exteavascular space.

20

What are the therapeutic uses for osmotic diuretics

Prevent kidney failure in specific situations such as hypocovolemic shock and severe hypotension
Decreases intracranial pressure caused by cerebral edema by drawing off fluid from the brain Into the bloodstream
It is administered for oliguria phase of acute kidney failure

21

What are adverse effects of osmotic diuretics

HF
pulmonary edema
Fluid and electrolyte imbalances

22

What is an extreme caution of osmotic diuretics

HF

23

What are med interactions of osmotic diuretics

Lithium excretion through the kidneys is increased
Monitor lithium levels

24

What are nursing considerations for diuretics

Administer mannitol by continuous IV infusion