lack of urine production, such as less than 100mL per day, due to Kidney Failure, UTO or Shock

Enlargement or swelling of breast tissue in males, a common side effect of Spironolactone due to its effect on aldosterone and androgen receptors.

Damage to the ear/hearing; a risk associated with rapid IV push administration of Loop diuretics like Furosemide.

Low serum potassium levels; symptoms include leg cramps, muscle weakness, and "U" waves on an EKG.

Increased skin sensitivity to UV light, requiring the use of high-SPF sunblock (common in Thiazides and Loops).

Low potassium (hypokalemia) caused by Loop diuretics increases the risk of Digoxin toxicity. The nurse must assess for visual changes (halos) and bradycardia.

Patients with severe allergies to sulfonamide antibiotics may have cross-sensitivity to Loop and Thiazide diuretics. Always verify with the provider before the first dose.

Thiazide diuretics require functioning kidneys to work. If a patient is in severe renal failure (Anuria), Thiazides are contraindicated as they cannot reach their site of action in the distal tubule.

Conserve potassium (K+); monitor for hyperkalemia (> 5.0\ mEq/L).

Potassium Dynamics * Loops/Thiazides:

Waste potassium (K+); monitor for hypokalemia (< 3.5\ mEq/L).

The Priority Rule (ABCs over BP)

While orthostatic hypotension is a common side effect of diuretics, electrolyte-induced cardiac dysrhythmias (indicated by muscle weakness or irregular pulse) are a higher priority because they affect circulation and electrical stability of the heart.

Why is an irregular heart rhythm a higher priority assessment finding than a drop in blood pressure for a patient on Furosemide?

the potential for the irregular heart rhythm to lead to life-threatening conditions such as arrhythmias, which can compromise the heart's ability to pump blood effectively.

What is the physiological reason that salt substitutes are dangerous for a patient on Spironolactone?

it counteracts the drugs mechanism for reducing fluid retention and BP, as salt causes fluid retention and rise of BP

How does the nurse evaluate if a diuretic has been effective for a patient with pulmonary edema specifically?

by checking daily weights and lung sounds for improvement as improved lung sounds indicates reduced pulmonary congestion and checking wts helps to assess fluid retention changes

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Cardiovascular Diure

STUDY GUIDE PHARM

Question	Answer
Anuria	lack of urine production, such as less than 100mL per day, due to Kidney Failure, UTO or Shock
Gynecomastia	Enlargement or swelling of breast tissue in males, a common side effect of Spironolactone due to its effect on aldosterone and androgen receptors.
Ototoxicity	Damage to the ear/hearing; a risk associated with rapid IV push administration of Loop diuretics like Furosemide.
Hypokalemia	Low serum potassium levels; symptoms include leg cramps, muscle weakness, and "U" waves on an EKG.
Photosensitivity	Increased skin sensitivity to UV light, requiring the use of high-SPF sunblock (common in Thiazides and Loops).
Digoxin Interaction	Low potassium (hypokalemia) caused by Loop diuretics increases the risk of Digoxin toxicity. The nurse must assess for visual changes (halos) and bradycardia.
The Sulfa Warning	Patients with severe allergies to sulfonamide antibiotics may have cross-sensitivity to Loop and Thiazide diuretics. Always verify with the provider before the first dose.
Renal Thresholds	Thiazide diuretics require functioning kidneys to work. If a patient is in severe renal failure (Anuria), Thiazides are contraindicated as they cannot reach their site of action in the distal tubule.
Potassium-Sparing	Conserve potassium (K+); monitor for hyperkalemia (> 5.0\ mEq/L).
Potassium Dynamics * Loops/Thiazides:	Waste potassium (K+); monitor for hypokalemia (< 3.5\ mEq/L).
The Priority Rule (ABCs over BP)	While orthostatic hypotension is a common side effect of diuretics, electrolyte-induced cardiac dysrhythmias (indicated by muscle weakness or irregular pulse) are a higher priority because they affect circulation and electrical stability of the heart.
Why is an irregular heart rhythm a higher priority assessment finding than a drop in blood pressure for a patient on Furosemide?	the potential for the irregular heart rhythm to lead to life-threatening conditions such as arrhythmias, which can compromise the heart's ability to pump blood effectively.
What is the physiological reason that salt substitutes are dangerous for a patient on Spironolactone?	it counteracts the drugs mechanism for reducing fluid retention and BP, as salt causes fluid retention and rise of BP
How does the nurse evaluate if a diuretic has been effective for a patient with pulmonary edema specifically?	by checking daily weights and lung sounds for improvement as improved lung sounds indicates reduced pulmonary congestion and checking wts helps to assess fluid retention changes
Which diuretic class is the drug of choice for a patient who needs to maintain potassium levels while losing fluid?	potassium sparing diuretics
Digoxin Antidote	DIGIFab

Created by: mmishue

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