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Diuretics

High Ceiling Loop, Thiazide, Potassium Sparing, Osmotic

QuestionAnswer
What are the mechanisms and adverse effects of: High Ceiling Loop Diuretics? blocks reabsorption of Na, Cl and H2O in ALOH assess pt for dehydration/hyponatremia/ hypochloremia/hypotension/hypokelmia/hypocalcemia in DM pts/ Digoxin and Lithium toxicity, ototoxicity
If a pt taking Diuretic has low output what should you do? Report it to the physician
What should you teach a pt with Hypotension who is taking a High Ceiling Loop Diuretic? to rise slowly, monitor bp and orthostatic hypotension.
What should you be monitoring when assessing a pt taking a High Ceiling Loop Directive for hypokalemia? Cardiac status and potassium levels
At what rate should you push potassium and why? 10MEQ/hr or less because it can cause death.
At what rate should you push a High Ceiling Loop Diuretic and why? 10-20mg/ min because it can cause hearing loss
What could be a sign of ototoxicity in a patient taking a Diuretic? Tinnitus
What are two important things to monitor with a pt. taking a High Ceiling Loop Diuretic? Daily weights and I/O
What are some key teaching points for pts. taking High Ceiling Loop Diuretics? Avoid in pregnancy sit up slowly eat foods high in potassium monitor blood glucose/ bp/ daily weight/ I&O Do not stop taking med w/o doctor approval take in the morning
Why is it recommended that patients take their diuretic in the morning? To avoid having to urinate during sleeping hours.
What is the prototype of High Ceiling Loop Diuretics? Furosemide (Lasix)
What is the prototype of Thiazide Diuretics? Hydrochlorothiazide (hydrodiuril)
What is the Mechanism and adverse side effects of Thiazide Diuretics? blocks absorption of sodium and chloride and prevents reabsorption of water at early distal convoluted tubule Dehydration/hyponatremia/hypochloremia/ hypokalemia/hypocalcemia/ototoxicity
What diuretic is usually the first choice? Thiazide Diuretic
What is a pt taking a Thiazide diuretic at lower or no risk for than a pt taking a Loop Diuretic? hypotension and hearing loss
What are some key teaching points for pts. taking Thiazide Diuretics? Eat a diet high in potassium take in the morning
What is the prototype of Potassium-Sparing Diuretics? Spironolactone (Aldactone)
What is the mechanism and adverse side effects of Potassium-Sparing Diuretic? blocks action of aldersterone resulting in potassium retention and secretion of sodium and water. avoid pts with kidney failure and anuria hyperkalemia endocrine dysfunction
Which diuretic takes a longer time for therapeutic effect? Potassium-Sparing Diuretics
Which pts never get potassium supplements? Pts experiencing hyperkalemia
When should you monitor potassium levels with pts taking potassium-sparing diuretics? When given with ACE inhibitors, angiotension receptor blockers, and direct renin inhibitors.
What are effects of endocrine dysfunction in pts taking potassium-sparing diuretics? impotence irregular menstrual cycles
What are some key teaching points for pts taking Potassium- Sparing Diuretics? avoid salt substitutes because they contain potassium triamterene may turn urine blue
What is the prototype of Osmotic Diuretics? Mannitol (Osmitrol)
What is the mechanism of Osmotic Diuretics? Draws fluid back to vascular space by raising serum osmolality to reduce intracranial and intraoccular pressure and to prevent kidney failure and hypovolemic shock. Usually only given in the ICU or ED with close monitoring Use cautiously in pts with HF
What are adverse effects of Osmotic Diuretics? kidney failure-nephrotoxicitiy- monitor kidneys hypernatremia-monitor eletrodes fluid overload- edema, respiratory and cardiac lithium levels- may decrease with hyponatremia monitor therapeutic effect monitor I/O, bp, serum electrolytes and kidneys
How do you administer Osmotic Diuretics? intravenously with continuous infusion through a filter needle
Created by: ksrq5d