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Ch. 42 Diuretics

QuestionAnswer
purpose of Diuretics? <hypertension and edema(peripheral and pulmonary) ; increase urine flow(diuresis)
diuretics have what type of effect? a antihypertensive effect because they promote sodium and water loss by blocking Na and Cl reabsorption.
Diuretics cause the loss of what? electrolytes: K, Mg, Cl, bicarbonate
when treating hypertension which type of diuretic is used. combination diuretis that are K sparing and wasting, they have a additive effect in reducing BP
what do the Thiazide diuretics do or act on? wk on distal convoluted renal tubules to promote Na, Cl,Mg and water excretion(promote Ca reabsorption). treat peripheral edema and hypertension.
are Thiazides effective for immediate diuresis(urine excretion)? no, not good to promote fluid loss in pt's w/severe renal dysfunction! USUALLY USED FOR PT'S W/NORMAL RENAL FUNCTION!!!
abnormal serum values associated w/Thiazide diuretics(causes excretion or retention) Hypokalemia(>digoxin action & digitilas toxicity;Hypomagnesemia,Hypercalcemia(same as kalemia)Hypocloremia,Hyperuricemia->uric acid, block excretion,Hyperglycemia->blood sugar
Hydrochlorothiazide-diuretic >digitalis toxicity, to increase urine output,
Thiazides should not be used for pt's w/renal failure. signs of renal failure are? Oliguria(< urine output), >BUN, and serum creatinine
Digitalis therapy prep given to pt w/ heart disorder to > force of myocardial contractions; produces a slower more regular apical rate
pg 646 thiazide assessment
Loop(high-ceiling)diuretics do what? wk on thick ascending loop of henle to inhibit Cl transport of Na into the circulation.loss of NA, water, K, Ca, Mg.
Loop(high-ceiling)diuretics affect what? blood sugar and >uric acid levels, THIS GROUP IS POTENT
Loop(high-ceiling)diuretics used to treat fluid retention/fluid overload from HF(heart failure)? Lasix(Furosemide)pg. 649
Lab changes seen w/Loop(high-ceiling)diuretics Hypokalemia;Hypomagnesemia,Hypercalcemia;Hypochloremia,Hyperglycemia->blood sugar;hyponatremia;>BUN & creatinine; >lipids <HDL; Thrombocytopenia and Leukocytopeina
decrease in platelet production which results in bleeding disorders thrombocytopenia
Physiological change with loop-diuretics Hypotension, Ototoxicity(hearing impairment), skin disturbances(Purpura), light sensitivity, hypovolemia(>extracellular fluid lost in urine)
Osmotic Diuretics increase what? the osmolality(concentration) of Na reabsorption in proximal tubule and loop of henle. THES ARE USED TO PREVENT KIDNEY FAILURE!
Mannitol is what and does what? potent osmotic K wasting diuretic used in Emergency cases for ICP(intracranil pressure) & IOP(intraocular pressure)
Mannitol side effects acidosis, tachycardia from rapid fluid loss, electrolyte loss, pulmonary edema
Carbonic anhydrase inhibitors block action of enzyme carbonic anhydrase. used for pt w/alkalosis
K-sparing diuretics Weaker than thiazides, used as a mild diuretic or w another diuretic. watch serum K levels(need to be <5.3)
Aldactone(Spironolactone) K-sparing diuretics, aldosterone antagonist. given to cardiac pt's because of it K sparing effect. produces more normal heart rate and < myocardial fibrosis. for edema also
K-sparing diuretics are combined with what to intnsify the diuretic effect and prevent K loss? combined w/K-wasting diuretics(hydochlorothiazides) or loop-diuretics.
K-sparing diuretics can cause what? hyperkalemia
K-sparing diuretics use w/ pt's of renal failure shoud be monitored because? most k is excreted from the kidneys and if they are inpaired the K toxicity could occur. report if urine output <600ml per day or <30ml per hour.
Created by: VRoberts
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