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201D Exam 5 > Diuretics > Flashcards

Diuretics Flashcards

(48 cards)

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1
Q

what are the kidneys primary functions?

A

maintenance of fluid balance

maintenance of acid-base balance

excretion of metabolic wastes

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2
Q

what are the kidneys secondary functions?

A

erythropoietin

renin (secreted by juxtaglomerular cells)

calcitriol

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3
Q

what does juxta mean?

A

next to

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4
Q

what does erythropoietin do?

A

tells bone marrow to make more RBCs

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5
Q

what triggers erythropoietin?

A

body senses hypoxia

kidneys and heart feel like they are not getting enough RBCs

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6
Q

nephron info

A

functional unit of the kidney

we have about 1,000,000 in EACH kidney

each one is about 2 inches long

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7
Q

afferent means that blood _________ the glomerulus and efferent means that blood ___________ the glomerulus

A

approaches
exits

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8
Q

glomerulus info

A

rich in blood, surrounded by Bowmen’s capsule (membrane)

functional unit of nephron that filters the filtrate

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9
Q

the filtration rate is determined by how well the ___________ functions

A

glomerulus

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10
Q

what is the path that the filtrate takes through the nephron?

A

water and small molecules are filtered into Bowmans capsule

through the proximal convoluted tubule (PCT)

through the loop of henle

the distal convoluted tubule (DCT)

to the collecting duct

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11
Q

what are the 4 basic renal processes?

A
  1. filtration
  2. reabsorption (resorption)
  3. secretion
  4. excretion
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12
Q

what is the peritubular capillary?

A

the capillary around the nephron

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13
Q

what are the 4 classes and actions of diuretics?

A
  1. loop diuretics
  2. thiazide diuretics
  3. potassium-sparing diuretics
  4. osmotic diuretics
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14
Q

define preload

A

the amount of blood volume that fills the ventricles in the diastole (relaxation) phase of the cardiac cycle (aka filling pressure)

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15
Q

define afterload

A

the pressure the ventricles must work against to open the valves so blood can leave the ventricles (aka peripheral vascular resistance)

pushing OUT to lungs or aorta

↑afterload = ↑cadiac workload

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16
Q

what is preload influenced by?

A

hypervolemia
heart failure
regurgitation of cardiac valves

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17
Q

what is afterload influenced by?

A

hypertension
vasoconstriction

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18
Q

loop diuretics are also called?

A

water pill

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19
Q

what is the prototypical loop diuretic?

A

furosemide

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20
Q

where does furosemide act?

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A

ascending loop of henle

21
Q

what does furosemide do? resulting in…

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A

blocks the reabsorption of Na (H2O) and Cl

dilates blood vessels

↓preload
↓afterload
↓BP

22
Q

what are the indications for loop diuretics?

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A

to manage hypertension (not 1st line)

↓edema r/t HF, liver, renal disease

23
Q

what are the adverse effects of loop diuretics?

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A

hypotension

Na, K, and other electrolyte depletion

possible hyperglycemia

24
Q

what is the prototypical thiazide diuretic?

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A

hydrochlorothiazide (HCTZ)

25
where does a thiazide diuretic work?
acts in DCT
26
what does a thiazide diuretic do? resulting in...
blocks reabsorption of Na, (H2O), CL, K RELAXES arterioles (not dilate) ↓preload ↓afterload ↓BP
27
what are the indications for thiazide diuretics?
first line tx for HTN (used for HTN more than HF) mild to moderate management of HTN adjunct tx for HF, liver disease
28
what are the adverse effects of thiazide diuretics?
electrolyte imbalance hypokalemia possible hyperglycemia
29
how does relaxing arterioles help?
reduce vasoconstriction which improves blood flow and less friction/shearing = less cholesterol plaques coming free and clotting
30
aldosterone is secreted by the __________
adrenal gland
31
what does aldosterone act on?
acts on DCT and collecting ducts
32
what does aldosterone do?
↑reabsorption of Na, H2O resulting in ↑blood volume and ↑BP (keeps us "profusing") excretion of K (when Na retained)
33
where is the adrenal gland located
"hat" on top of the kidney
34
what is the prototypical potassium-sparing diuretic?
spironolactone
35
where does the potsssium-sparing diuretic act?
DCT and the collecting ducts
36
what does the drug spironolactone do?
it is an aldosterone-antagonist it blocks the reabsorption of Na, H2O retains K
37
what are the indications for potassium sparing diuretics?
management of HTN edema r/t HF, liver, renal disease counteract K loss caused by other diuretics
38
what are the adverse effects of potassium sparing diuretics?
hyperkalemia orthostatic hypotension hypovolemia
39
what is the prototypical osmotic diuretic?
mannitol
40
where does the osmotic diuretic work?
PCT and descending limb
41
how does mannitol work? and what are the results?
↑osmotic force (to draw fluid into the tubule) inhibits H2O reabsorption produces rapid diuresis (related to drug concentration)
42
what are the indications for an osmotic diuretic?
edema (very severe) ↑intracranial pressure
43
what are the adverse effects of an osmotic diuretic?
dehydration (strict I/O)
44
what are the effects of diuretics on geriatric patients?
take dose in am can cause dizziness orthostatic hypotension ↑risk dehydration and constipation ↓ doses w/ other diuretics and HTN med ↑ F&E imbalances
45
potassium supplements are contraindicated for what type of diuretic?
potassium-sparing diuretics (spironolactone)
46
what are the general nursing implications for diuretics?
D= diet I= I/O U= unbalanced F&E R= ready for dynamic changes E= no evening doses T= take in am I= ↑orthostatic hypotension C=consider age
47
what are the "dynamic changes" related to diuretics?
light-headedness VS heart and breath sounds (crackles) cardiac rhythm
48
for hydration purposes what do we see if high or low?
BUN, electrolytes and creatinine will be elevated when H2O levels go down

201D Exam 5 (3 decks)

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