Ch 19 Urinary Output Flashcards

1
Q

What is the expected pharmalogical action of loop diuretics

A

They work in the ascending loop of henle
Blocks reabsorption of sodium and chloride to prevent reabsorption of water.
Causes extensive diuresis even with severe renal impairment

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2
Q

What are the therapeutic uses of loop diuretics

A

They are used when there is need for the rapid administration of fluid
They are used for pulmonary edema caused by HF
They are used in conditions not responsive to other diuretics, such as edema caused by liver, cardiac, or kidney disease or HTN

THESE MEDS MAY ALSO BE USED TO TREAT HYPERCALCEMIA R/T KINDNEY STONE FORMATION

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3
Q

What are adverse effects of loop diuretics

A
Dehydration
Hyponatremia
Hypochloremia
Hypotension
Hypokalemia
Decrease in calcium and magnesium levels
Ototoxicity ( transient with furosemide and irreversible with Ethacrynic acid)
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4
Q

What are high potassium foods

A

Bananas, potatoes, Dried fruits, nuts, spinach, citrus fruit

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5
Q

What are signs of hypokalemia

A

Nausea/ vomiting

General weakness

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6
Q

What is a medication interaction of loop diuretics

A

Digoxin
Ventricular dysrhythmias can occur in the presence of HYPOKALEMIA
Concurrent use with antihypertensives can cause additive hypotensive effect.
Lithium serum levels can be increased which leads to toxicity
NSAIDS decrease blood flow to kidneys which reduces the diuretic effect

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7
Q

What are signs of low magnesium

A

Weakness

Muscle twitching

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8
Q

How can a nurse recognize that the loop diuretics worked

A

Decrease in pulmonary or peripheral edema
Weight loss
Decrease in BP
increase in urinary output

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9
Q

Thiazide diuretics select prototype drug

A

Hydrochlorothiazide ( Hydrodiuril)

Other drugs; chlorothiazide ( Diuril)
methyclothiazide ( Enduron)

Thiazides type diuretics-
Indapamidem( Lozide, Lozol)
Chlorthalidone ( Hygroton)
Metolazone ( Zaroxolyn)

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10
Q

How do Thorazine diuretics work

A

They work in the early distal convoluted tubule
Blocks the reabsorption of sodium and chloride, and prevents the reabsorption of water at this site
Promotes diuresis when renal function is not impaired

They are often the 1st med of choice for essential HTN
these meds may be used for edema to mild to moderate HF and liver and kidney disease.

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11
Q

What are adverse effects of thiazides diuretics

A

Dehydration
Hypokalemia
Hyperglycemia

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12
Q

What are pre assessments of the drug thiazides diuretics

A
Obtain clients baseline data including 
Orthostatic BP
weight
Electrolytes
And location and extent of edema
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13
Q

Potassium sparing diuretics

A

Prototype drug; spironolactone ( Aldactone)

Other drugs; triamterene ( Dyrenium) amiloride ( Midamor)

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14
Q

What is the expected pharmalogical action of potassium sparing diuretics

A

Blocks the action of aldosterone ( sodium and water rentention) which results in potassium rentention and the excretion of sodium and water

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15
Q

What are the therapeutic uses of potassium sparing diuretics

A

Oral administration
Used for HF
May take 12-48 hours for effect

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16
Q

What are the side effects of potassium sparing diuretics

A

Hyperkalemia

Endocrine effects..impotence in men, irregularities in menstrual cycle for woman.

17
Q

What are med interactions of potassium sparing diuretics

A

ACE INHIBITORS increase the risk of hyperkalemia

18
Q

Triamterene may turn the urine what color

A

A bluish color

19
Q

What are osmotic diuretics

A

Osmotic diuretics reduce intracranial pressure and intraocular pressure by raising serum osmolality and drawing fluid back into the vascular and exteavascular space.

20
Q

What are the therapeutic uses for osmotic diuretics

A

Prevent kidney failure in specific situations such as hypocovolemic shock and severe hypotension
Decreases intracranial pressure caused by cerebral edema by drawing off fluid from the brain Into the bloodstream
It is administered for oliguria phase of acute kidney failure

21
Q

What are adverse effects of osmotic diuretics

A

HF
pulmonary edema
Fluid and electrolyte imbalances

22
Q

What is an extreme caution of osmotic diuretics

A

HF

23
Q

What are med interactions of osmotic diuretics

A

Lithium excretion through the kidneys is increased

Monitor lithium levels

24
Q

What are nursing considerations for diuretics

A

Administer mannitol by continuous IV infusion

25
Q

High ceiling loop diuretics

A

Prototype: furosemide (Lasix)

Other drugs: Ethacrynic ( Edecrin)
Bumetanide ( Bumex)
Torsemide ( Demadex)