Diuretics - Urine Output Flashcards
categories of diuretics + overall effect
PLOT: potassium-sparing loop osmotic thiazide
overall effect: get rid off excess fluid
-change electrolyte
*potassium-sparing diuretics
drug names
TEAS: Triamterene Eplerenone Amiloride Spironolactone
potassium-sparing diuretics (TEAS)
MOA
-blocks the action of aldosterone on the renal cortex
aldosterone action
reabsorbs Na
secretes K
potassium-sparing diuretics (TEAS)
Tx
- to get rid of excess fluid
- often combined to avoid electrolyte problems
potassium-sparing diuretics (TEAS)
CI
- severe kidney failure
- anuria
- caution w ACE/ARB/DRI
*potassium-sparing diuretics (TEAS)
A/E
- hyper-K
- hypo-Na (lithium danger)
- endocrine effects (weird sex stuff)
- drowsiness
- metab acidosis
what are some s/s of the endocrine effects of potassium-sparing diuretics (TEAS)
- deep voice
- gynecomastia
- hirsute
- irreg menstrual cycle
*potassium-sparing diuretics (TEAS)
RN/teaching
- reduce high K food or K supplemenents
- Triamterene makes your pee blue green
- if pt is hyper-K, then cardiac monitor
- concurrent use w ACE, ARB, DRI can incr risk of hyper-K
Insulin MOA
uptake of glucose + K
priority treatments for patient w hyper-K
- IV push of Ca gluconate or CaCl 10%
- —does NOT stabilize K levels
- —DOES stabilize heart walls
- Insulin + D50
- Neb Betal Agonist (Albuterol)
- IV Na Bicarbonate (decr acid, drives K into cell)
- Polystyrene sulfonate/Kayexylate
- loop diuretics
- dialysis
which is the strongest diuretic?
LOOP
-thiazide is just like loop but not as strong
**LOOP diurects
drug name
furosemide (Lasix)
Ethacrynic acid
Bumetanide
furosemide, ethacrynic acid, bumetanide (loop)
MOA
block reabsorption of Na + Cl
furosemide, ethacrynic acid, bumetanide (loop)
Tx
- HTN
- edema
- CHF
- hyper-Ca
- hyper-K
*furosemide, ethacrynic acid, bumetanide (loop)
CI
-caution w LITHIUM, DIGOXIN, NSAID, + anti HTN
*furosemide, ethacrynic acid, bumetanide (loop)
A/E
- dehydration
- drop BP
- hypo-Na
- hypo-K
- hypo-Ca
- hypo-Mg
- hyper-glucose
- ototoxicity
- tinnitus
*furosemide, ethacrynic acid, bumetanide (loop)
RN/teaching
- monitor I/O
- daily weights
- UOP <30mL/Hr
- tinnitus
- chvostek’s trousseau’s
- monitor K levels
- daily weight in
- orthohypotension
always check for ___ before giving K or diuretics
BP
if patient is at risk for orthohypotension, what should we be on the lookout for?
ambulation + getting up too fast
-def encourgae getting up slowly
what are some things to consider for a patient that requires daily weigh ins?
same time
same clothing or bedding
low K makes ___ toxic
Digoxin
low Na makes ___ toxic
Lithium
low Ca makes cause ____
Chvostek + Trousseau
+also hypo-Mg
