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