Diuretics Overview and Types Unit 7.2
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Questions and Answers

Which of the following are types of diuretics?

  • Osmotic (correct)
  • Thiazide and thiazide-like (correct)
  • Potassium-sparing (correct)
  • Loop or high-ceiling (correct)
  • What is the specific action of thiazide diuretics?

    Thiazide diuretics act on the distal convoluted renal tubule, promoting the excretion of sodium, potassium, and water.

    Which of the following is a common side effect of thiazide diuretics?

  • Dizziness
  • GI distress
  • Photosensitivity
  • All of the above (correct)
  • Thiazide diuretics are contraindicated in patients with renal failure.

    <p>True</p> Signup and view all the answers

    What is the specific action of loop diuretics?

    <p>They inhibit water and sodium reabsorption in the ascending loop of Henle.</p> Signup and view all the answers

    Which of the following is a potential adverse reaction of loop diuretics?

    <p>All of the above</p> Signup and view all the answers

    Loop diuretics are contraindicated in patients with severe electrolyte imbalance and hypovolemia.

    <p>True</p> Signup and view all the answers

    What is the main use of osmotic diuretics like mannitol?

    <p>Osmotic diuretics like mannitol are primarily used to reduce intracranial pressure and intraocular pressure, particularly in emergency situations.</p> Signup and view all the answers

    Which of the following is NOT a side effect of osmotic diuretics?

    <p>Hypokalemia</p> Signup and view all the answers

    Osmotic diuretics are contraindicated in patients with heart disease and heart failure?

    <p>True</p> Signup and view all the answers

    What is the primary action of potassium-sparing diuretics like spironolactone?

    <p>Potassium-sparing diuretics like spironolactone block the action of aldosterone, leading to sodium and water excretion while promoting potassium retention.</p> Signup and view all the answers

    What is a common use of potassium-sparing diuretics?

    <p>Control of fluid retention in heart failure</p> Signup and view all the answers

    Which of the following is NOT a side effect of potassium-sparing diuretics?

    <p>Hypokalemia</p> Signup and view all the answers

    Potassium-sparing diuretics are contraindicated in patients with severe kidney/renal disease and hyperkalemia.

    <p>True</p> Signup and view all the answers

    A client is taking furosemide (Lasix) for heart failure and hypertension. It is most important for the nurse to assess the client for the development of which electrolyte imbalance?

    <p>Hypokalemia</p> Signup and view all the answers

    When teaching a client about loop diuretics, which statement concerning medication timing is important?

    <p>Take the medication with a meal.</p> Signup and view all the answers

    A client is admitted to the intensive care unit with increased intracranial pressure. The nurse would anticipate administering which medication?

    <p>Mannitol (Osmitrol)</p> Signup and view all the answers

    A client is receiving furosemide (Lasix). The nurse should monitor the client for the development of which electrolyte imbalance?

    <p>Hypokalemia</p> Signup and view all the answers

    A client with congestive heart failure gains 5 pounds in 1 week. This most likely indicates a fluid weight gain of how many liters?

    <p>2 L</p> Signup and view all the answers

    Before administering Spironolactone, it is most important for the nurse to determine if the client is also receiving which medication?

    <p>Potassium chloride (K-Dur)</p> Signup and view all the answers

    Which statement about aldosterone is true?

    <p>It is a mineralocorticoid hormone.</p> Signup and view all the answers

    What is the action of thiazide diuretics in the kidneys?

    <p>Promote sodium, potassium, and water excretion</p> Signup and view all the answers

    What are some uses of thiazide diuretics?

    <p>Both A and B</p> Signup and view all the answers

    Thiazide diuretics are contraindicated in renal failure.

    <p>True</p> Signup and view all the answers

    What is the action of loop diuretics like furosemide?

    <p>Inhibit water and sodium reabsorption. Potassium, magnesium, and calcium can also be excreted.</p> Signup and view all the answers

    What are some uses for loop diuretics?

    <p>All of the above</p> Signup and view all the answers

    What is a possible side effect of loop diuretics if administered too quickly intravenously?

    <p>Hearing loss</p> Signup and view all the answers

    Loop diuretics are contraindicated in severe electrolyte imbalance.

    <p>True</p> Signup and view all the answers

    What type of diuretic is mannitol?

    <p>Osmotic diuretic</p> Signup and view all the answers

    What is a common use for mannitol?

    <p>All of the above</p> Signup and view all the answers

    Mannitol is contraindicated in heart disease and heart failure.

    <p>True</p> Signup and view all the answers

    What is the action of potassium-sparing diuretics like spironolactone?

    <p>Block the action of aldosterone and promote sodium excretion. Potassium, magnesium, and calcium can also be excreted.</p> Signup and view all the answers

    What are some uses for potassium-sparing diuretics?

    <p>Both A and B</p> Signup and view all the answers

    Which of the following is a common side effect of potassium-sparing diuretics?

    <p>All of the above</p> Signup and view all the answers

    Potassium-sparing diuretics are contraindicated in severe kidney or renal disease and hyperkalemia.

    <p>True</p> Signup and view all the answers

    What are some common nursing assessments for patients on diuretics?

    <p>All of the above</p> Signup and view all the answers

    What are some common nursing interventions for patients on diuretics?

    <p>All of the above</p> Signup and view all the answers

    A client is taking furosemide (Lasix) for heart failure and hypertension. What electrolyte imbalance is the nurse likely to be most concerned about?

    <p>Hypokalemia</p> Signup and view all the answers

    A client is admitted to the intensive care unit with increased intracranial pressure. What type of diuretic is the nurse likely to administer?

    <p>Mannitol (Osmitrol)</p> Signup and view all the answers

    A client is receiving furosemide (Lasix). What electrolyte imbalance is the nurse most likely to monitor for?

    <p>Hypokalemia</p> Signup and view all the answers

    A client with congestive heart failure gains 5 pounds in 1 week. What is the most likely fluid weight gain?

    <p>2 L</p> Signup and view all the answers

    Before administering spironolactone, what medication is important to ask about?

    <p>Potassium chloride (K-Dur)</p> Signup and view all the answers

    Which of the following statements about aldosterone is true?

    <p>It is a mineralocorticoid hormone</p> Signup and view all the answers

    Study Notes

    Diuretics Overview

    • Diuretics are medications that increase urine output.
    • Various types of diuretics exist, each acting on different parts of the kidney.

    Types of Diuretics

    • Thiazide and thiazide-like
    • Loop or high-ceiling
    • Osmotic
    • Potassium-sparing

    Thiazide Diuretics - Hydrochlorothiazide

    • Action: Acts in the kidneys, promoting sodium, potassium, and water excretion. Specifically targets the distal convoluted renal tubule
    • Uses: Treatment of hypertension and edema from heart failure
    • Side effects/adverse reactions: Dizziness, headache, weakness, GI distress, photosensitivity, fluid/electrolyte imbalances, hypotension, hyperglycemia, hypokalemia, and dysrhythmias
    • Contraindications: Renal failure, electrolyte depletion, caution for hepatic dysfunction, diabetes mellitus
    • Interactions: Increased risk of digoxin toxicity with hypokalemia, with anti-diabetic drugs and steroids

    Loop Diuretics - Furosemide

    • Action: Inhibits water and sodium reabsorption. Also potassium, magnesium, and calcium are excreted. Acts on the ascending loop of Henle.
    • Uses: Treatment of fluid retention from conditions like heart failure, renal dysfunction, cirrhosis, hypertension and pulmonary edema.
    • Side effects/adverse reactions: GI stress, dizziness, weakness, photosensitivity, fluid and electrolyte imbalances, orthostatic/hypotension, hyperglycemia, and hearing loss (especially during IV administration).
    • Contraindications: Severe electrolyte imbalance, hypovolemia, allergy to sulfa drugs, caution with heart failure, diabetes
    • Interactions: Anticoagulants (increased bleeding), steroids (increased potassium loss), digoxin (if hypokalemia is present).

    K-Wasting Diuretics – Lab Abnormalities

    • Serum chemistry abnormalities include: hypokalemia, hypomagnesemia, hypochloremia, hyponatremia, hyperglycemia, and hypocalcemia often in loop diuretics. Hypercalcemia can be found in thiazide diuretics

    Osmotic Diuretics - Mannitol

    • Action: Causes water, sodium, chloride, and potassium excretion through kidneys.
    • Uses: Decrease intracranial pressure, decrease intraocular pressure, promote excretion of toxic substances, often used in emergencies.
    • Side effects/adverse reactions: GI upset, fluid and electrolyte imbalance, pulmonary edema from rapid fluid shifts, tachycardia related to rapid fluid loss, acidosis, caution with heart disease, heart failure, and renal failure.

    Potassium-Sparing Diuretics - Spironolactone

    • Action: Blocks aldosterone action, which promotes sodium and water excretion in the kidneys and increases potassium retention; also excretes magnesium and calcium. May increase blood glucose.
    • Uses: Treating heart failure and hepatic cirrhosis
    • Side effects/adverse reactions: GI distress, dizziness, weakness, erectile dysfunction, orthostatic hypotension, fluid and electrolyte imbalance, and hyperkalemia
    • Contraindications: Severe kidney/renal disease, hyperkalemia
    • Interactions: Potassium supplements, ACE inhibitors, angiotensin II receptor blockers, and salt substitutes containing potassium.

    Nursing Process: Assessment

    • Medication/medical history
    • Vital signs
    • Fluid and electrolyte levels/weight
    • Renal/hepatic function
    • Allergies

    Nursing Process: Interventions

    • Monitor I&O, daily weights.
    • Notify healthcare provider if urine output doesn't increase.
    • Monitor blood pressure and other vital signs.
    • Slowly administer IV furosemide.
    • Watch for hypokalemia s/s with k-wasting diuretics; watch for hyperkalemia s/s with k-sparing diuretics.
    • Monitor electrolyte levels.
    • Monitor blood glucose values periodically.

    Nursing Process: Teaching

    • Take BP before dose; monitor weight daily. Report weight gain of 2lbs overnight or 5lbs in a week
    • Take medication in the morning.
    • Okay to take with food.
    • If Gl upset, take with food.
    • Stay out of sun with photosensitivity.
    • Get up slowly from sitting/lying position
    • Reinforce need for compliance
    • Diet changes - include potassium-rich foods if client is on k-wasting diuretics. Avoid diet high in potassium if on k-sparing diuretics.
    • Drug interactions – potassium supplements, ACE inhibitors, and angiotensin II receptor blockers and salt substitutes

    Practice Questions and Answers (with rationales)

    • Various practice questions related to diuretic use and client management are included in the document
    • Provided rationales to accompany the answers.

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    Unit 7.2 Diuretics PDF

    Description

    This quiz covers the various types of diuretics, including thiazide, loop, osmotic, and potassium-sparing diuretics. It details their mechanisms of action, uses, side effects, and contraindications. Test your knowledge about these essential medications and their impact on kidney function.

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