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anticoalgulant
Pharmacology, Nursing, diuretics
| Question | Answer |
|---|---|
| Diuretics | Increase urine output |
| How do diuretics work? | By increasing glomerular filtration rate and decreasing tubule reabsorption |
| What are the classes of diuretics? | Thiazides, High Ceiling (loop), Osmotics, Carbonic Anhydrase Inhibitors, Potassium Sparing |
| How do thiazides work? | By decreasing the reabsorption of Mg, Na, Cl, water, carbonic acid, and K. Also, it increases the reabsorption of glucose, Ca and lipids. |
| What is the prototype for thiazides? | HCTZ hydroclorothiazide |
| What are some clinical uses for diuretics? | to treat hypertension and edema. To decrease interocular pressure and to soften the eye for surgery. |
| HCTZ | hydrochlorozide. The prototype for thiazides. |
| What is the prototype for high ceiling diuretics? | Lasix/furosemide |
| How do high ceiling/loop diuretics work? | By decreasing reabsorption of Ca, Na and Cl. |
| What are they key features of thiazides? | They are not a strong diuretic, they take 2 hours to start working, they can be used to treat hypercalcemia in the urine, they are a poor choice to use on diabetics and risk of allergy in people who are allergic to sulfonamides. |
| What are common adverse effects of diuretics? | hypotension, fluid deficit, hypokalemia, hyponatrimia, hyperglycemia |
| What are some causes of edema? | heart failure, renal failure, poor circulation |
| Polyurea | large urine output |
| Oligurea | small urine output |
| Anurea | no urine output |
| Edema | excessive fluid in the tissues |
| Hypokalemia | low levels of serum potassium |
| How is mannitol/Osmitrol administered? | By IV only |
| mannitol/Osmitrol | osmotic diuretic |
| Why would you need to monitor hr and rhythm when using potassium sparing diuretics? | abnormal potassium affects the conduction of cardiac nerve impulses and myocardial contraction |
| How do potassium sparing diurectics work? | Promotes the loss of sodium and retains potassium |
| What is a risk with using an osmotic diuretic? | hypervolemia then hypovalemia |
| What are the key features of high ceiling diuretics? | stronger/faster onset of action, sodium restriction is often needed, treats hypercalcemia, is ototoxic |
| Which diuretic would you use to treat anuria, increased IOP, and/or edema? | Osmotic diuretics |
| spironolactone/Aldactone | potassium sparing diuretic |
| Explain how osmotic diuretics affect the blood volume | fluid is drawn from the tissues into the blood, as the blood filters through the kidneys, water is excreted. If too much water is excreted then hypovalemia can occur. |
| How do carbonic anhydrase inhibitors work? | by inhibiting bicarbonate reabsorption and by inhibiting production of aqueous humor and cerebrospinal fluid |
| What is the prototype for the osmotic diuretic? | mannitol/Osmitrol |
| What are clinical uses for osmotic diurectics? | Used to treat anuria, increased IOP, and edema |
| How do osmotic diuretics work? | By increasing osmotic pressure in blood and in the glomerular filtrate. |
| What are the key features of potassium sparing diuretics? | There is the potential for hyperkalemia, potassium supplements are not needed, monitor hr and rhythm. |
| What is the potassium sparing diuretic? | spironolactone/Aldactone |
| Why is a sodium restriction needed in conjunction with use of a high ceiling diuretic? | post-diuretic rebound effect |
| furosemide/Lasix | high ceiling (loop) diuretic |
| why are thiazides a poor choice as a diuretic for pts w/diabetes? | b/c it increases serum gluose and lipids |
| Why are thiazides useful in treating elevated urine calcium? | B/c it increases reabsorption of Ca. (meaning less Ca in the urine!) |
| Carbonic anhydrase inhibitor prototype? | acetazolamide/Diamox |
| What are the key points of carbonic anhydrase inhibitors? | Reduces IOP and ICP (intercranial pressure)also decreases blood pH. |
| When your pt is on diuretics what do you need to monitor? | I&O, weight, edema, serum electrolytes, neuromuscular status, serum glucose and mental status. |
| When your pt is on a diuretic, what should you see on thier I&O? | output should be higher than input |
| What is the best method for detecting fluid loss or gain? | daily weight |
| Where is edema most prevalent? | ankles, on the back (when pt is on bed rest). And auscultation of the lungs may reveal pulmonary edema. |
| Serum glucose is most likely to be affected by which type of diuretic? | Thiazides |
| assessment of reflexes and muscle tone may be indicative of ____. This is important b/c _____. | electrolyte imbalance; impulse conduction and muscle activity depend on specific concentrations of electrolytes. |
| cerebral edema causes ______. | confusion or decreased alertness. |
| What are signs of hypovolemia? | hypotension, tachycardia, dry mucous membranes and concentrated urine. |
| What are signs of hypokalemia? | irregular pulse, hypotension, weak respirations, muscle weakness, and abdominal distention. |
| What do you need to know about administering potassium? | always dilute and give slowly |
| In a pt w/hyponatremia, what would you assess for? | Hypotension, tachycardia, oliguria, confusion, and abdominal cramps. |
| In a pt w/hypocalcemia what would you assess for? | neuromuscular irritability |
| In a pt w/hypercalcemia what would you assess for? | depressed neuromuscular function |
| What do you need to do to treat hypocalcemia? | provide Ca as ordered |
| How do you treat hypercalcemia? | encourage fluids to prevent urinary stones, administer a high ceiling diuretic as ordered |
| What should you include in pt teaching about diuretics? | take diuretics in the morning, report muscle weakness, palpations, muscle cramps, confusion, reduce sodium intake (as ordered), salt subtitutes contain potassium |
| acetazolamide/Diamox | Carbonic anhydrase inhibitor |
| Which group of pts are at higher risk for sodium depletion? | the elderly |
Created by:
mercerw
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