Week 11: Diuretics, and Electrolytes (15 questions)

Question 1

Carbonic Anhydrase Inhibitors (CAIs)

Acetazolamide

asses for what allergy?
observe cues of?
increase what? and why?
Report?

Answer 1

allergies to sulfonamides

Observe for cues of hypokalemia

Increase fluids (can cause crystals)

Report numbness and tingling

Question 2

Loop Diuretics

Increase excretion of what?

Don’t give loop diuretic if?

loop diuretics cause what?

Answer 2

water, sodium, and, potassium

potassium is 3.5 or lower

loop diuretics cause hypokalemia

Question 3

Loop Diuretic:

Furosemide
(Most common loop diuretic)

Can also be used for?
Black box warning for?
Adverse effects?
Obtain weight when?
take med when?
eat foods high in what?

Answer 3

Can also be used to treat ascites

Black box warning for fluid and electrolyte loss

Assess for tinnitus and hearing loss

obtain weight at the same time each day (preferably in the morning after urinating)

take med in the morning

EAT HIGH POTASSIUM

Question 4

Potassium-Sparing Diuretics

spironolactone

monitor?
commonly causes?
may cause increase in?
avoid?

Answer 4

Monitor electrolytes, BUN, and Cr

Commonly causes hyperkalemia

May cause increase in BUN, Cr, and uric acid

avoid salt substitute and foods that contain high potassium

Question 5

Thiazide and Thiazide-Like Diuretics

Hydrochlorothiazide

used how?
dosage over 50?
ok to use low doses?
Monitor for?

Answer 5

Used in combination with other drugs.
Less of other drug needs to be used

Ceiling effect; dosages over 50 mg/day rarely produce additional
clinical results

OK to use low doses (12.5-25 mg) in pregnancy

leg cramps

Question 6

Osmotic Diuretics

Mannitol

Used to reduce?
What form?
What happens if bag is cold?
Stop if client has?

Answer 6

Used to reduce intracranial pressure & cerebral edema

IV only

May crystallize when exposed to low temperatures. warm up or send back to pharmacy

Cardiac arrest or SEVERE renal impairment

Question 7

Electrolyte Replacement Therapy

Potassium

Normal value?
Hypokalemia symptoms?
low potassium can increase what toxicity?

Answer 7

3.5 to 5

Hypotension
Lethargy
Mental confusion
Muscle weakness
Nausea

low potassium can increase toxicity associated with digoxin

Question 8

How to administer IV Potassium
(dilute it)

PIV?
Central line

Answer 8

PIV: No faster than 10
Central line: No faster than 20

Question 9

Hyperkalemia symptoms? 5.0+

Greater than 7 can cause?

Answer 9

Generalized fatigue and malaise
Weakness
Paresthesia
Palpitations
Paralysis

> 7 mEq/L can cause ventricular fibrillation and cardiac arrest

Question 10

Administering Potassium

PO?
administer with?

Answer 10

Very irritating to GI tract (can cause ulcers)

Administer w water or food

Question 11

Treatment of mild to moderate hyperkalemia?

What is it called?
Works where?
Don’t give to who?

Answer 11

Sodium polystyrene sulfonate

Works in intestine

Do not give to patient who do not have normal bowel function

Question 12

Treatment of severe hyperkalemia?

if between 5.5-6.5?
if greater than 6.5?
Why is insulin given?
What’s given in emergencies?

Answer 12

If between 5.5.-6.5 mEq/L, may use diuretics to lower potassium

> 6.5:
1.IV sodium bicarbonate
2. dextrose with insulin
3. calcium gluconate

Insulin is given to prevent hypoglycemia, rapidly redistributes
potassium into the cells

4. Hemodialysis (in emergencies) to remove excess potassium**
   (LAST RESORT)