NUR 210, 242 -Exam 3 Pharm Study Guide (100% correct).
Exam 3 pharm study guide Loop, potassium-sparing, and thiazide diuretics
Drug
... [Show More] classification
Thiazides
Thiazide-like diuretics
Loop
High ceiling diuretics
Thiazide
Action
Potassium-sparing
Potassium sparing diuretics
Acts on the distal convoluted renal tube. Promotes sodium, chloride, and water excretion
Indications
Hydrochlorothiazide
Decrease blood pressure
Decrease amount of fluid within the body Treats peripheral edema
Side effects
Hyperglycemia Hypercalcemia Hypokalemia Dizziness Vertigo
Adverse reactions
Cardiac dysrhythmias Orthostatic hypotension Severe hypokalemia
Contraindications
Renal failure Diabetes
Interactions
Digoxin
Herbal products
Loop diuretics
Action
Act on the loop on henle by inhibiting chloride transport of sodium and passive
reabsorption of sodium.
As more fluid is passed out by the kidneys, less fluid remains in the bloodstream Indications
Furosemide
HF
Renal dysfunction Hypertension
Peripheral and pulmonary edema
Side effects
Electrolyte imbalances
Decrease in potassium, magnesium, sodium, calcium Hyperglycemia
Dizziness Headache Adverse reactions
Hypokalemia Hyponatremia Hypomagnesemia Orthostatic hypotension Renal failure
Contraindications
Severe electrolyte imbalance Hypovolemia
Anuria
Diabetes mellitus Hypotension
Interactions
Digoxin-risk for digitalis toxicity Lithium
Potassium-sparing
Action
Blocks the action of aldosterone
Promotes sodium and water excretion and promotes potassium retention Indications
Spironolactone
Edema/fluid retention Hypertension Congestive heart failure Kidney disease
Side effects
Dizziness GI upset Weakness Headache
Adverse reactions
Hyperkalemia Hepatoxicity
Contraindications
Severe kidney and liver disease Interactions
Potassium supplements Ace inhibitors
Diuretics and the nursing process Assessment (for all diuretics)
Baseline vitals
Weight pt
Look for third spacing Medical history Peripheral edema Baseline labs
Electrolytes, potassium, magnesium, and glucose Urine output
Interventions
Monitor urine output Daily weight Monitor vitals
Loop diuretics
IV very slowly to avoid hearing loss Thiazide and loop diuretics
Watch for hypokalemia (low potassium) Potassium sparing diuretics
Watch for hyperkalemia (high potassium) Hypokalemia ( low potassium) s/s
Muscle weakness Cramps
Cardiac dysrhythmias Hyperkalemia (high potassium) s/s
Nausea Diarrhea
Abdominal cramping Tingling In hands and feet
Pt evaluation
Decrease in bp or within normal limits Increase urine output
Decrease in fluid retention Weight goes down
Pt teaching
Diet-either high or low potassium Loop or thiazide: eat more potassium Potassium sparing: eat less potassium s/s of hyper or hypokalemia
teach pt to stand up slowly
pt should take meds in the morning
daily weights: 1 or 2lbs daily shift is normal loop diuretics: stronger and not self-limiting thiazide diuretics: self-limiting
Summary
Thiazide Diuretics
It is important to monitor electrolytes in patients taking thiazide diuretics.
Patients should see decrease in BP and peripheral edema. Teach the patient about signs and symptoms of hypokalemia.
Loop Diuretics
Loop Diuretics are used to treat Heart failure, HTN, and peripheral edema. During the nursing intervention, it is important to monitor electrolytes.
Signs and symptoms of hypokalemia are muscle weakness/cramps and cardiac dysrhythmias.
Potassium-Sparing Diuretics
Potassium sparing diuretics are used to treat hypertension, edema, and heart failure.
During a nursing intervention, it is important to monitor electrolyte levels, at risk for hyperkalemia.
Potassium sparing diuretics may not be given with ACE inhibitors.
Osmotic diuretics
Classifications
Osmotic diuretic
Action more water.
Increases osmolality and sodium reabsorption in the proximal tubule, drawing in Kidneys excrete sodium, chloride, potassium, and water
Indications
Mannitol
Increased cranial pressure Cerebral edema
Increased ocular pressure Prevent renal failure
Side effects
Electrolyte imbalances GI problems
Adverse reactions
Pulmonary edema Tachycardia Acidosis
Contraindications [Show Less]