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Flashcards in Diuretic Drugs Deck (32):
0

Furosemide (Lasix)
(Functional Classification)

Loop Diuretic

1

Furosemide (Lasix)
(Chemical Classification)

Sulfonamide derivative

2

Furosemide (Lasix)
(Mechanism of Action)

Inhibits reabsorption of sodium and chloride at proximal and distal tubule and in the loop of Henle

3

Furosemide (Lasix)
(Uses)

Pulmonary edema; edema with CHF, hepatic disease, nephrotic syndrome, ascites, hypertension

4

Furosemide (Lasix)
(Contraindications)

Breastfeeding, infants, anuria, hypovolemia, electrolyte depletion

5

Furosemide (Lasix)
(Side Effects)

CNS: headache, fatigue, weakness, vertigo, paresthesias
CV: orthostatic hypotension, chest pain, ECG changes, CIRCULATORY COLLAPSE
EENT: loss of hearing, ear pain, tinnitus, blurred vision
ELECT: Hypokalemia, Hypochloremic Alkalosis, Hypomagnesemia, Hyperuricemia, Hypocalcemia, Hyponatremia, metabolic alkalosis
ENDO: Hyperglycemia
GI: Nausea, diarrhea, dry mouth, vomiting, anorexia, cramps, oral, gastric irritations, pancreatitis
GU: Polyuria, RENAL FAILURE, glycosuria
HEMA: THROMBOCYTOPENIA, AGRANULOCYTOSIS, LEUKOPENIA, NEUTROPENIA, ANEMIA
INTEG: Rash, Pruritus, purpura, STEVENS-JOHNSON SYNDROME, sweating, photosensitivity, urticaria
MS: cramps, stiffness

6

Furosemide (Lasix)
(Nursing Considerations)

ASSESS:
-CHF: weight, I&O daily to determine fluid loss; effect of product may be decreased if used daily
-HYPERTENSION: BP lying, standing; postural hypotension may occur
-Metabolic alkalosis: drowsiness, restlessness
-HYPOKALEMIA: postural hypotension, malaise, fatigue, tachycardia, leg cramps, weakness
-Rashes, temp elevation daily
-Confusion, especially in geriatric patients; take safety precautions if needed
-HEARING, including tinnitus and hearing loss, when giving high doses for extended periods
-Rate, depth, rhythm of respiration, effect of exertion, lung sounds
-Electrolytes (potassium, sodium, chloride); include BUN, blood glucose, CBC, serum creatinine, blood pH, ABGs, uric acid
-Glucose in urine if patient diabetic
-Allergies to sulfonamides, thiazides

PERFORM/PROVIDE
-Increased fluid intake 2-3L/day unless contraindicated

7

Furosemide (Lasix)
(Overdose Treatment)

Lavage if taken orally; monitor electrolytes; administer dextrose in saline; monitor hydration, CV, renal status

8

Hydrochlorothiazide
(Functional Classification)

Thiazide diuretic, antihypertensive

9

Hydrochlorothiazide
(Chemical Classification)

Sulfonamide derivative

10

Hydrochlorothiazide
(Mechanism of Action)

Acts on distal tubule and ascending limb of loop of Henle by increasing excretion of water, sodium, chloride, potassium

11

Hydrochlorothiazide
(Uses)

Edema, hypertension, diuresis, CHF; edema in corticosteroid, estrogen, NSAIDs; idiopathic lower extremity edema therapy

12

Hydrochlorothiazide
(Contraindications)

Hypersensitivity to thiazides or sulfonamides, anuria, renal decompensation, hypomagnesemia

13

Hydrochlorothiazide
(Side Effects)

CNS: drowsiness, paresthesia, depression, headache, Dizziness, Fatigue, Weakness, fever
CV: irregular pulse, orthostatic hypotension, palpitations, volume depletion, allergic myocarditis
EENT: blurred vision
ELECT: Hypokalemia, hypercalcemia, hyponatremia, hypochloremia, hypomagnesemia
GI: Nausea, Vomiting, Anorexia, constipation, diarrhea, cramps, pancreatitis, GI irritation, HEPATITIS
GU: Urinary Frequency, polyuria, UREMIA, GLUCOSURIA, hyperuricemia
HEMA: APLASTIC ANEMIA, HEMOLYTIC ANEMIA, LEUKOPENIA, AGRANULOCYTOSIS, THROMBOCYTOPENIA, NEUTROPENIA
INTEG: Rash, urticaria, purpura, photosensitivity, alopecia, erythema multiforme
META: Hyperglycemia, Hyperuricemia, increased creatinine, BUN

14

Hydrochlorothiazide
(Nursing Considerations)

ASSESS:
-Weight, I&O daily to determine fluid loss; effect of product may be decreased if used daily
-Rate, depth, rhythm of respiration, effect of exertion
-BP lying, standing; postural hypotension may occur
-Blood studies: BUN, blood glucose, CC, serum creatinine, blood pH, ABGs, uric acid, electrolytes
-SIGNS OF METABOLIC ALKALOSIS: drowsiness, restlessness
-SIGNS OF HYPOKALEMIA: postural hypotension, malaise, fatigue, tachycardia, leg cramps, weakness, dehydration
-Confusion, especially in geriatric patients; take safety precautions if needed

15

Hydrochlorothiazide
(Overdose Treatment)

Lavage if taken orally; monitor electrolytes; administer dextrose in saline; monitor hydration, CV, renal status

16

Mannitol
(Functional Classification)

Diuretic, osmotic

17

Mannitol
(Chemical Classification)

Hexahydric Alcohol

18

Mannitol
(Mechanism of Action)

Acts by increasing osmolarity of glomerular filtrate, which inhibits reabsorption of water and electrolytes and increases urinary output

19

Mannitol
(Uses)

Edema; promotion of systemic diuresis in cerebral edema; decreased in intraocular/intracranial pressure; improved renal function in acute renal failure, chemical poisoning

20

Mannitol
(Contraindications)

Active intracranial bleeding, hypersensitivity, anuria, severe pulmonary congestion, edema, severe dehydration, progressive heart, renal failure

21

Mannitol
(Side Effects)

CNS: dizziness, headache, SEIZURES, REBOUND INCREASED ICP, confusion
CV: edema, thrombophlebitis, hypo/hypertension, TACHYCARDIA, angina-like chest pains, fever, chills, CHF, CIRCULATORY OVERLOAD
EENT: loss of hearing, blurred vision, nasal congestion, decreased intraocular pressure
ELECT: fluid, electrolyte imbalances, Acidosis, electrolyte loss, dehydration, hypo/hyperkelemia
GI: Nausea, Vomiting, dry mouth, diarrhea
GU: marked diuresis, urinary retention, thirst
RESP: pulmonary congestion

22

Mannitol
(Nursing Considerations)

ASSESS:
-Weight, I&O daily to determine fluid loss; effect of product may be increased if used daily; output every hour prn
-Rate, depth, rhythm of respiration, effect of exertion
-BP lying, standing; postural hypotension may occur
-Electrolytes: potassium, sodium, chloride; include BUN, CBC, serum creatinine, blood pH, ABGs, CVP, PAP
-METABOLIC ACIDOSIS: drowsiness, restlessness
-HYPOKALEMIA: postural hypotension, malaise, fatigue, tachycardia, leg cramps, weakness, or hyperkalemia
-rashes, temp daily
-confusion, especially in geriatric patients; take safety precautions if needed
-Hydration including skin turgor, thirst, dry mucous membranes
-Blurred vision, pain in eyes before, during treatment (INCREASED INTRAOCULAR PRESSURE); neurologic checks, intracranial pressure during treatment (INCREASED INTRACRANIAL PRESSURE)

23

Mannitol
(Overdose treatment)

Discontinue inf; correct fluid, electrolyte imbalances; hemodialysis, monitor hydration, CV status, renal function

24

Spironolactone (Aldactone)
(Functional Classification)

Potassium-Sparing Diuretic

25

Spironolactone (Aldactone)
(Chemical Classification)

Aldosterone Antagonist

26

Spironolactone (Aldactone)
(Mechanism of Action)

Completes with aldosterone at receptor sites in distal tubule, thereby resulting in the excretion of sodium chloride and water and the retention of potassium and phosphate

27

Spironolactone (Aldactone)
(Uses)

edema of CHF, hypertension, diuretic-induced hypokalemia, primary hyperaldosteronism (diagnosis, short-term treatment, long-term treatment), edema of nephrotic syndrome, cirrhosis of liver with ascites

28

Spironolactone (Aldactone)
(Contraindications)

Pregnancy (D), hypersensitivity, anuria, severe renal disease, hyperkalemia

29

Spironolactone (Aldactone)
(Side Effects)

CNS: Headache, confusion, drowsiness, lethargy, ataxia,
ELECT: hyperchloremic metabolic acidosis, HYPERKALEMIA, hyponatremia
ENDO: impotence, gynecomastia, irregular menses, amenorrhea, postmenopausal bleeding, hirsutism, deepening voice, breast pain
GI: Diarrhea, cramps, BLEEDING, gastritis, Vomiting, anorexia, nausea, HEPATOCELLULAR TOXICITY
HEMA: AGRANULOCYTOSIS
INTEG: Rash, Pruritus, urticaria

30

Spironolactone (Aldactone)
(Nursing Considerations)

ASSESS:
-HYPOKALEMIA: polyuria, polydipsia; dysrhythmias, including a u wave on ECG
-HYPERKALEMIA: weakness, fatigue, dyspnea, dysrhythmias, confusion, fatigue
-Electrolytes: sodium, chloride, potassium, BUN, serum creatinine, ABGs, CBC
-Weight, I&O daily to determine fluid loss; effect of product may be decreased if used daily; ECG periodically with long-term therapy
-Signs of metabolic acidosis: drowsiness, restlessness
-Rashes,temp daily
-Confusion, especially in geriatric patients; take safety precautions if needed
-Hydration: skin turgor, thirst, dry mucous membranes

31

Spironolactone (Aldactone)
(Overdose Treatment)

Lavage if taken orally; monitor electrolytes, administer IV fluids, monitor hydration, renal, CV status