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Diuretic Therapy LPN

28.1: Nursing Implications for Diuretic Therapy Goodcare LPN 2018

Common sites to check skin turgor Weight gain that alerts the patient or nurse to increasing edema is generally 2 lbs in 2 days Over the sternum, on the forehead, and on the forearm.
Weight gain that alerts the patient or nurse to increasing edema Generally 2 lbs in 2 days
Required Evaluations in diuretic therapy dehydration: skin turgor, oral mucous membranes; location of edema, signs of reduction
Monitor laboratory values for changes. T or F True
Obtain daily weights Measure intake and output Assessment for Hydration
Restricted sodium diet Potassium intake depends on type of diuretic prescribed Nursing Process Implementation with Diuretics
Keep urinal or bedpan available Nursing Process Implementation with Diuretics
Heart failure Edema, adventitious lung sounds, dyspnea, change in mental status Conditions Contributing to Excess Fluid
Liver disease Ascites, cirrhosis, cancer Conditions Contributing to Excess Fluid
Renal disease Renal failure Conditions Contributing to Excess Fluid
History of related causative disorders/factors History of current symptoms Pattern of urination Medication history Hydration status Electrolyte imbalance Renal Function: Assessment
Often subtle changes, such as in mental status, muscle strength/cramps, tremors, nausea, general appearance Electrolyte imbalance
Used to increase flow of urine to reduce excess water in the body Primarily used to treat heart failure, hypertension Diuretics
Other uses: liver disease, renal disease, cerebral edema, increased intraocular pressure, treat hypercalcemia Diuretics
reduce edema, improve symptoms of excess fluid Therapeutic outcomes of diuretics
Act on the kidneys to decrease reabsorption of sodium, chloride, and water. Diuretics
the sites of action for thiazide and potassium-sparing drugs. The distal tubules
the site of action for loop diuretics. The loop of Henle
indicates volume depletion; potassium level shows diuresis is occurring too rapidly orthostatic blood pressure
Take in the morning to prevent nocturia Report gain of 2 lbs in 2 days Medication considerations for diuretics
Accurate measurement of fluid intake and output Purpose of diuresis Medication considerations Nutrition Health maintenance Written record/patient self-assessment form Patient Education Considerations
Can cause weakness of cardiovascular, respiratory, digestive, and skeletal muscles Potassium depletion
Susceptible people: history of renal or cardiac disease, hormonal disorders, massive trauma or burns Electrolyte Imbalance
Electrolyte Imbalance values Serum potassium < 3.5 mEq/L (hypokalemia), > 5.5 mEq/L (hyperkalemia)
Required assessments for Electrolyte Imbalance Assess mental status, muscle strength and cramps, tremors, nausea, general appearance
Electrolyte Imbalance values Serum sodium) < 135 mEq/L (hyponatremia), > 145 mEq/L (hypernatremia
Drug: acetazolamide (Diamox) Carbonic Anhydrase Inhibitor
Weak diuretic; inhibit the enzyme carbonic anhydrase in kidney, brain, eye Actions of acetazolamide (Diamox)
Reduce intraocular pressure with glaucoma; reduce seizure activity with certain types of epilepsy Uses ofacetazolamide (Diamox)
bumetanide (Bumex), furosemide (Lasix), ethacrynic acid (Edecrin), torsemide (Demadex). Sulfonamide-Type Loop Diuretics
Loop Diuretic used to treat hypertension. Furosemide
More effective than other loop diuretics in patients with significant renal failure. Ethacrynic acid
Inhibit sodium and chloride reabsorption in ascending limb of the loop of Henle Actions of Sulfonamide-Type Loop Diuretics
Treat conditions such as edema resulting from heart failure, cirrhosis of the liver, renal disease Uses of Sulfonamide-Type Loop Diuretics
Oral irritation, dry mouth; orthostatic hypotension Common adverse effects of Sulfonamide-Type Loop Diuretics
Serious adverse effects of Sulfonamide-Type Loop Diuretics GI: gastric irritation, abdominal pain Electrolyte imbalance: dehydration, hypokalemia, hyperglycemia Hypersensitivity: hives, rash, pruritus
Drug interactions of Sulfonamide-Type Loop Diuretics Alcohol, barbiturates, narcotics: orthostatic hypotension aggravated Digoxin: may cause excessive potassium excretion, hypokalemia, digitalis toxicity
Used for more long-term management of heart failure and hypertension. Thiazide Diuretics
Not strong diuretics; have a slow onset of action. Thiazide Diuretics
Treat edema associated with heart failure, renal disease, hepatic disease, pregnancy, obesity, premenstrual syndrome Uses of Thiazide Diuretics
Block reabsorption of sodium and chloride ions from the tubule Actions of Thiazide Diuretics
Common adverse effects of Thiazide Diuretics Orthostatic hypotension
Serious adverse effects of Thiazide Diuretics GI: gastric irritation, nausea, vomiting Electrolyte imbalance: hypokalemia, other changes, hyperglycemia Hyperuricemia Hypersensitivity
Digoxin: may increase risk for toxicity Other medications also Drug interactions of Thiazide Diuretics
Instruct patients not to use salt substitutes, which are high in potassium, to prevent hyperkalemia. Contraindicated in patients with renal impairment because of high risk of hyperkalemia. Potassium-Sparing Diuretics
Contraindicated in patients with renal impairment because of high risk of hyperkalemia. Potassium-Sparing Diuretics
Drugs: amiloride (Midamor), spironolactone (Aldactone), triamterene (Dyrenium) Potassium-Sparing Diuretics
Actions of Potassium-Sparing Diuretics Induce retention of potassium; excrete sodium at the distal renal tubules
Uses of Potassium-Sparing Diuretics In combination with other diuretics to treat hypertension or heart failure, prevent hypokalemia
Common and serious adverse effects of Potassium-Sparing Diuretics Nausea, vomiting, anorexia, flatulence, headache, electrolyte imbalance, dehydration
Electrolyte imbalance: hyperkalemia Serious adverse effects of Potassium-Sparing Diuretics
Drug interactions of Potassium-Sparing Diuretics ACE inhibitors, ARBs may increase risk for hyperkalemia Potassium supplements, certain salt substitutes may increase risk of hyperkalemia
Actions of Combination Diuretic Products Potassium-sparing diuretics/thiazide diuretics
Uses of Combination Diuretic Products Promote diuresis while maintaining normal potassium levels
Common adverse effects of Combination Diuretic Products Hyperkalemia, hyponatremia
Combination Diuretic Products Spironolactone/hydrochlorothiazide (Aldactazide) Triamterene/hydrochlorothiazide (Dyazide, Maxzide) Amiloride/hydrochlorothiazide (Moduretic)
Created by: TutorDavis17