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Flashcards in Diuretics and Electrolytes Deck (48)
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What is the function of the kidneys?

1. regulating fluid balance, electrolyte balance, and acid-base balance
2. Regulates blood pressure through the RAAS
3. Regulates RBC production
4. Filtrates, Reabsorbs, and Excretes into Nephron*


What substances are secreted by the kidneys?

1. Renin
2. Erythropoietin
3. Calcitriol


Function of the Nephron

filters fluid and makes urine


Function of Bowman's Capsule

filter that allows fluid in, but keeps large particles out (protein)


Function of Glomerulus

Group of blood vessels that allow fluid and waste passage


Describe the flow of Filtrate through the body

Kidneys --> Nephron --> Glomerulus --> Proximal Tubule --> Loop of Henley --> Distal Tubule --> Collecting duct --> out of body


What is a diuretic?

drug that reduces fluid volume in the body and increases urine output.


Uses of diuretics include

1. Hypertension**
2. CHF
3. Cirrhosis or liver failure
4. Renal disease
5. Increased intracranial pressure
6. Pulmonary edema
7. Glaucoma


What is the pharmodynamics of diuretics?

1. Block sodium and water reabsorption in the nephron, sending more sodium into the urine to be excreted

2. Increases urine output (diuresis)


What does the effectiveness of a diuretic depend on?

1. The part of the tubule affected by the drug
2. The potency of the drug


What should the nurse assess prior to administering diuretics and why?

1. Complete Health Hx
2. Electrolytes (lose fluid=lose electrolytes)
3. CBC (diuretics may cause agranulocytosis)
4. Liver/Renal fx (risk for toxicity)
5. Weight (daily, same time and scale, consistency is key)
6. Blood Pressure (fluid loss=hypotension)
7. Breath sounds (crackles = diuretics may be ineffective)
8. Cardiac Monitoring (hand in hand with electrolytes)


What should the nurse monitor after administering diuretics?

1. VS/Electrolytes/BUN&Creatinine
2. Signs of gout (certain diuretics may cause hyperuricemia leading to gout flare ups)


What are the normal BUN and Creatinine levels?

BUN: 10-20
Creatinine: 0.5-1.2


Normal Electrolyte Balances? (K, Na, Mg, Ca)

K: 3.5-5
Na: 135-145
Mg: 1.5-2.5
Ca: 9-10.5


What is the relationship between Na and Water?

Where Na goes, Water follows


How is Hypernatremia Treated?

Depends on underlying cause
1. Hypotonic Fluids
2. Na restricted diet
3. Diuretics (not common)


How is Hyponatremia Treated?

Na replacement
- oral Na/isotonic fluid if asymptomatic
- IV for neuro decline or very severe


S/S of Hypernatremia

1. Dehydrated/Thirsty
2. Tachycardia
3. Irritable/Restlessness
4. Altered LOC


S/S of Hyponatremia

1. Lethargy
2. Headache
3. Confusion
4. Seizure
5. Coma


What causes hypermagnesemia?

1. Abuse of antacids
2. Laxatives
3. Renal failure


What causes hypomagnesemia?

1. Use of diuretics
2. Alcoholism


S/S of Hyperkalemia

1. Muscle fatigue
2. Weakness
3. Paralysis
4. Abnormal heart rhythms (arrhythmias)
5. Nausea


S/S of Hypokalemia

1. Severe V/D
2. Metabolic Alkalosis
3. Respiratory Alkolosis


What does Furosemide do?

1. Blocks the chloride pump in the ascending loop of Henle
2. Decreases reabsorption of sodium and chloride
3. Causes diuresis even with severe renal impairment

Blocks sodium reabsorption which means Na stays as well as Cl & waste leading to diuresis


Why would you administer furosemide?

1. Pulmonary edema
2. Edema caused by liver, cardiac, or kidney disease or HTN
3. To treat hypercalcemia related to kidney stone formation


Adverse effects of Furosemide

1. Dehydration
2. Hypotension
3. Electrolyte imbalance
4. Ototoxicity


S/S of Hypermagnesemia

1. N/V
2. Muscle Weakness
3. Hypotension
4. Bradycardia
5. Respiratory Depression


S/S of Hypomagnesemia

1. Tetany/Tremors
2. Confusion/Depression/Irritability
3. Nystagmus
4. Malnutrition/Malabsorption


Nursing Interventions for Diuretics

1. Monitor Daily Weights
2. Strict I&Os
3. Monitor BP
4. Monitor Electrolytes


Nursing Interventions/Pt Education for Furosemide

1. Eat High K foods
2. Monitore glucose and uric acid levels
3. Use cautiously in diabetic/gout patients
4. Dont give in evening/night