Podcast
Questions and Answers
What is the primary action of thiazide diuretics?
What is the primary action of thiazide diuretics?
Which of the following is a side effect of thiazide diuretics?
Which of the following is a side effect of thiazide diuretics?
Which diuretic acts on the ascending loop of Henle?
Which diuretic acts on the ascending loop of Henle?
In which condition are thiazide diuretics contraindicated?
In which condition are thiazide diuretics contraindicated?
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Which of the following is a use of loop diuretics?
Which of the following is a use of loop diuretics?
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What potential interaction should be monitored when using thiazide diuretics?
What potential interaction should be monitored when using thiazide diuretics?
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Which side effect is specifically associated with thiazide diuretics?
Which side effect is specifically associated with thiazide diuretics?
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What is a characteristic of potassium-sparing diuretics?
What is a characteristic of potassium-sparing diuretics?
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What is one of the primary uses of spironolactone?
What is one of the primary uses of spironolactone?
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Which side effect is associated with spironolactone?
Which side effect is associated with spironolactone?
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What condition contraindicates the use of spironolactone?
What condition contraindicates the use of spironolactone?
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Which electrolyte imbalance is a concern when taking spironolactone?
Which electrolyte imbalance is a concern when taking spironolactone?
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What is a recommended teaching point for a patient taking spironolactone?
What is a recommended teaching point for a patient taking spironolactone?
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When can spironolactone be taken with food?
When can spironolactone be taken with food?
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Why is it important for patients on potassium-sparing diuretics like spironolactone to monitor their diet?
Why is it important for patients on potassium-sparing diuretics like spironolactone to monitor their diet?
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Which class of drugs should be avoided when taking spironolactone?
Which class of drugs should be avoided when taking spironolactone?
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What is the primary function of osmotic diuretics like mannitol?
What is the primary function of osmotic diuretics like mannitol?
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Which electrolyte imbalance should a nurse monitor for in a client taking furosemide (Lasix)?
Which electrolyte imbalance should a nurse monitor for in a client taking furosemide (Lasix)?
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How much fluid weight gain corresponds to a 5-pound increase in a client with congestive heart failure?
How much fluid weight gain corresponds to a 5-pound increase in a client with congestive heart failure?
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What is the most critical pre-administration assessment for spironolactone?
What is the most critical pre-administration assessment for spironolactone?
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What symptom is most clearly associated with excessive use of loops diuretics like furosemide?
What symptom is most clearly associated with excessive use of loops diuretics like furosemide?
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Which condition is often treated with osmotic diuretics?
Which condition is often treated with osmotic diuretics?
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Why is potassium chloride usually not indicated for a client taking spironolactone?
Why is potassium chloride usually not indicated for a client taking spironolactone?
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What is a common result of using diuretics like mannitol and furosemide?
What is a common result of using diuretics like mannitol and furosemide?
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What is a side effect commonly associated with loop diuretics?
What is a side effect commonly associated with loop diuretics?
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Which condition is a contraindication for the use of loop diuretics?
Which condition is a contraindication for the use of loop diuretics?
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What electrolyte imbalance can result from potassium-wasting diuretics?
What electrolyte imbalance can result from potassium-wasting diuretics?
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What action does osmotic diuretics, like Mannitol, primarily accomplish?
What action does osmotic diuretics, like Mannitol, primarily accomplish?
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Which drug interaction can increase the risk of bleeding when taking anticoagulants?
Which drug interaction can increase the risk of bleeding when taking anticoagulants?
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Which diuretic is primarily used in emergency situations for its rapid effects?
Which diuretic is primarily used in emergency situations for its rapid effects?
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What can result from the rapid fluid loss associated with osmotic diuretics?
What can result from the rapid fluid loss associated with osmotic diuretics?
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What is the main action of potassium-sparing diuretics?
What is the main action of potassium-sparing diuretics?
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Which side effect is associated with the rapid administration of furosemide?
Which side effect is associated with the rapid administration of furosemide?
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What condition is commonly treated with loop diuretics?
What condition is commonly treated with loop diuretics?
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What should the nurse primarily assess for in a client using loop diuretics?
What should the nurse primarily assess for in a client using loop diuretics?
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What statement should the nurse include when teaching a client about taking loop diuretics?
What statement should the nurse include when teaching a client about taking loop diuretics?
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What dietary recommendation should a nurse give a client taking loop diuretics?
What dietary recommendation should a nurse give a client taking loop diuretics?
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What is the expected outcome when administering furosemide?
What is the expected outcome when administering furosemide?
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What should the nurse monitor for in a client receiving mannitol for increased intracranial pressure?
What should the nurse monitor for in a client receiving mannitol for increased intracranial pressure?
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Which medication is commonly used to treat increased intracranial pressure?
Which medication is commonly used to treat increased intracranial pressure?
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What is a potential side effect of loop diuretics that the nurse should inform the client about?
What is a potential side effect of loop diuretics that the nurse should inform the client about?
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How should the nurse instruct the client to take loop diuretics to minimize sleep disturbances?
How should the nurse instruct the client to take loop diuretics to minimize sleep disturbances?
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Study Notes
Diuretics
- Diuretics are medications that increase urine output.
- Several types of diuretics exist for different purposes
Types of Diuretics
- Thiazide and thiazide-like (e.g., hydrochlorothiazide)
- Loop or high-ceiling (e.g., furosemide)
- Osmotic (e.g., mannitol)
- Potassium-sparing (e.g., spironolactone)
Thiazide Diuretics - Hydrochlorothiazide
- Action: Works in the kidneys, promotes excretion of sodium, potassium, and water. Acts on the distal convoluted renal tubule.
- Uses: Treating hypertension, edema from heart failure
- Side Effects/Adverse Reactions: Dizziness, headache, weakness, GI distress, photosensitivity, fluid and electrolyte imbalances, hypotension (including orthostatic hypotension), hyperglycemia, hypokalemia, and dysrhythmias.
- Contraindications: Renal failure, electrolyte depletion, hepatic dysfunction, diabetes mellitus
- Interactions: Increased digoxin toxicity with hypokalemia, Anti-diabetic drugs, Steroids
Loop Diuretics - Furosemide
- Action: Inhibits water and sodium reabsorption; potassium, magnesium, and calcium are also excreted. Acts on the ascending loop of Henle.
- Uses: Treating fluid retention (caused by heart failure, renal dysfunction, cirrhosis, hypertension, pulmonary edema)
- Side Effects/Adverse Reactions: GI distress, dizziness, weakness, photosensitivity, fluid and electrolyte imbalances, orthostatic hypotension, hypotension, hyperglycemia, hearing loss (especially with rapid IV administration).
- Contraindications: Severe electrolyte imbalance, hypovolemia, allergy to sulfa drugs, caution with heart failure and diabetes
- Interactions: Anticoagulants (increased bleeding risk), Steroids (increased potassium loss), Digoxin (if hypokalemia is present).
K-Wasting Diuretics Lab Abnormalities
- Hypokalemia
- Hypomagnesemia
- Hypochloremia
- Hyponatremia
- Hyperglycemia
- Hypocalcemia in loop diuretics
- Hypercalcemia in thiazide diuretics
Osmotic Diuretics - Mannitol
- Action: Causes water, sodium, chloride, potassium to be excreted through the kidneys.
- Use: Decrease intracranial pressure (e.g., cerebral edema), decrease intraocular pressure, promote excretion of toxic substances. Usually used in emergency situations
- Side Effects/Adverse Reactions: GI upset, fluid and electrolyte imbalance, pulmonary edema, tachycardia, rapid fluid loss/acidosis, extreme caution, heart disease, heart failure, renal failure
Potassium-Sparing Diuretics - Spironolactone
- Action: Blocks the action of aldosterone, thereby promoting sodium and water excretion, and potassium retention; also excretes magnesium and calcium. Can increase blood glucose.
- Uses: Treating heart failure, hepatic cirrhosis
- Side Effects/Adverse Reactions: GI distress, dizziness, weakness, erectile dysfunction, orthostatic hypotension, hypotension, fluid and electrolyte imbalance, hyperkalemia
- Contraindications: Severe kidney/renal disease, hyperkalemia
- Interactions: Potassium supplements, ACE inhibitors and angiotensin II receptor blockers, salt substitutes containing potassium
Nursing Process: Diuretics
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Assessment: Medication/medical history, vital signs, fluid and electrolyte levels/weight, renal/hepatic function, allergies
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Interventions: Monitor I&O, daily weight, notify healthcare provider if urine output doesn't increase, monitor vitals (especially blood pressure), administer IV furosemide slowly, watch for signs of hypokalemia/hyperkalemia, monitor electrolyte levels, monitor glucose periodically
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Teaching: Take before dose, weigh daily, take with food (if GI upset), avoid sun (if photosensitivity), get up slowly, reinforce need for medication, potassium-wasting diets should increase potassium, potassium supplements may be necessary, potassium-sparing diets should decrease potassium; inform patient that some drugs may increase glucose
Practice Questions (with answers and rationale)
- (Note: The practice questions and rationales from the provided slides are included below.)*
- Question 1:* A client taking furosemide... Answer: C (low serum potassium, sodium, magnesium, and calcium) Rationale: Loop diuretics cause potassium loss
- Question 2:* Which statement about loop diuretics... Answer: C (Rise slowly to prevent dizziness) Rationale: The medication is taken in the morning, not at bedtime and with food.
- Question 3:* A client with increased intracranial pressure... Answer: B (mannitol (Osmitrol))
- Question 4:* A client receiving furosemide... Answer: B (hypokalemia) Rationale: Furosemide is a potassium-wasting diuretic.
- Question 5:* A client with congestive heart failure... Answer: C (2L) Rationale: Weight gain of 2.2 pounds is equivalent to excess 1 liter of fluid.
- Question 6:* Before administering spironolactone... Answer: B (digoxin (Lanoxin)) Rationale: Spironolactone is a potassium-sparing diuretic. Potassium supplementation is not indicated unless the client's potassium is low.
- Question 7:* Which statement about aldosterone... Answer: B (is a mineralocorticoid hormone) Rationale: Promotes sodium retention and potassium excretion
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Description
This quiz covers the various types of diuretics, their actions, uses, side effects, and contraindications. You will learn about thiazide diuretics, specifically hydrochlorothiazide, as well as loop and potassium-sparing diuretics. Test your knowledge of these important medications.
