Diuretics and Electrolytes Flashcards Preview

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Flashcards in Diuretics and Electrolytes Deck (48)
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1

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*

2

What substances are secreted by the kidneys?

1. Renin
2. Erythropoietin
3. Calcitriol

3

Function of the Nephron

filters fluid and makes urine

4

Function of Bowman's Capsule

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

5

Function of Glomerulus

Group of blood vessels that allow fluid and waste passage

6

Describe the flow of Filtrate through the body

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

7

What is a diuretic?

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

8

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

9

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)

10

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

11

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)

12

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)

13

What are the normal BUN and Creatinine levels?

BUN: 10-20
Creatinine: 0.5-1.2

14

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

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

15

What is the relationship between Na and Water?

Where Na goes, Water follows

16

How is Hypernatremia Treated?

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

17

How is Hyponatremia Treated?

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

18

S/S of Hypernatremia

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

19

S/S of Hyponatremia

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

20

What causes hypermagnesemia?

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

21

What causes hypomagnesemia?

1. Use of diuretics
2. Alcoholism

22

S/S of Hyperkalemia

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

23

S/S of Hypokalemia

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

24

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

25

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

26

Adverse effects of Furosemide

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

27

S/S of Hypermagnesemia

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

28

S/S of Hypomagnesemia

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

29

Nursing Interventions for Diuretics

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

30

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