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Questions and Answers
Which of the following are types of diuretics?
Which of the following are types of diuretics?
What is the specific action of thiazide diuretics?
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?
Which of the following is a common side effect of thiazide diuretics?
Thiazide diuretics are contraindicated in patients with renal failure.
Thiazide diuretics are contraindicated in patients with renal failure.
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What is the specific action of loop diuretics?
What is the specific action of loop diuretics?
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Which of the following is a potential adverse reaction of loop diuretics?
Which of the following is a potential adverse reaction of loop diuretics?
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Loop diuretics are contraindicated in patients with severe electrolyte imbalance and hypovolemia.
Loop diuretics are contraindicated in patients with severe electrolyte imbalance and hypovolemia.
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What is the main use of osmotic diuretics like mannitol?
What is the main use of osmotic diuretics like mannitol?
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Which of the following is NOT a side effect of osmotic diuretics?
Which of the following is NOT a side effect of osmotic diuretics?
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Osmotic diuretics are contraindicated in patients with heart disease and heart failure?
Osmotic diuretics are contraindicated in patients with heart disease and heart failure?
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What is the primary action of potassium-sparing diuretics like spironolactone?
What is the primary action of potassium-sparing diuretics like spironolactone?
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What is a common use of potassium-sparing diuretics?
What is a common use of potassium-sparing diuretics?
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Which of the following is NOT a side effect of potassium-sparing diuretics?
Which of the following is NOT a side effect of potassium-sparing diuretics?
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Potassium-sparing diuretics are contraindicated in patients with severe kidney/renal disease and hyperkalemia.
Potassium-sparing diuretics are contraindicated in patients with severe kidney/renal disease and hyperkalemia.
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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?
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?
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When teaching a client about loop diuretics, which statement concerning medication timing is important?
When teaching a client about loop diuretics, which statement concerning medication timing is important?
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A client is admitted to the intensive care unit with increased intracranial pressure. The nurse would anticipate administering which medication?
A client is admitted to the intensive care unit with increased intracranial pressure. The nurse would anticipate administering which medication?
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A client is receiving furosemide (Lasix). The nurse should monitor the client for the development of which electrolyte imbalance?
A client is receiving furosemide (Lasix). The nurse should monitor the client for the development of which electrolyte imbalance?
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A client with congestive heart failure gains 5 pounds in 1 week. This most likely indicates a fluid weight gain of how many liters?
A client with congestive heart failure gains 5 pounds in 1 week. This most likely indicates a fluid weight gain of how many liters?
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Before administering Spironolactone, it is most important for the nurse to determine if the client is also receiving which medication?
Before administering Spironolactone, it is most important for the nurse to determine if the client is also receiving which medication?
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Which statement about aldosterone is true?
Which statement about aldosterone is true?
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What is the action of thiazide diuretics in the kidneys?
What is the action of thiazide diuretics in the kidneys?
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What are some uses of thiazide diuretics?
What are some uses of thiazide diuretics?
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Thiazide diuretics are contraindicated in renal failure.
Thiazide diuretics are contraindicated in renal failure.
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What is the action of loop diuretics like furosemide?
What is the action of loop diuretics like furosemide?
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What are some uses for loop diuretics?
What are some uses for loop diuretics?
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What is a possible side effect of loop diuretics if administered too quickly intravenously?
What is a possible side effect of loop diuretics if administered too quickly intravenously?
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Loop diuretics are contraindicated in severe electrolyte imbalance.
Loop diuretics are contraindicated in severe electrolyte imbalance.
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What type of diuretic is mannitol?
What type of diuretic is mannitol?
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What is a common use for mannitol?
What is a common use for mannitol?
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Mannitol is contraindicated in heart disease and heart failure.
Mannitol is contraindicated in heart disease and heart failure.
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What is the action of potassium-sparing diuretics like spironolactone?
What is the action of potassium-sparing diuretics like spironolactone?
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What are some uses for potassium-sparing diuretics?
What are some uses for potassium-sparing diuretics?
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Which of the following is a common side effect of potassium-sparing diuretics?
Which of the following is a common side effect of potassium-sparing diuretics?
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Potassium-sparing diuretics are contraindicated in severe kidney or renal disease and hyperkalemia.
Potassium-sparing diuretics are contraindicated in severe kidney or renal disease and hyperkalemia.
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What are some common nursing assessments for patients on diuretics?
What are some common nursing assessments for patients on diuretics?
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What are some common nursing interventions for patients on diuretics?
What are some common nursing interventions for patients on diuretics?
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A client is taking furosemide (Lasix) for heart failure and hypertension. What electrolyte imbalance is the nurse likely to be most concerned about?
A client is taking furosemide (Lasix) for heart failure and hypertension. What electrolyte imbalance is the nurse likely to be most concerned about?
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A client is admitted to the intensive care unit with increased intracranial pressure. What type of diuretic is the nurse likely to administer?
A client is admitted to the intensive care unit with increased intracranial pressure. What type of diuretic is the nurse likely to administer?
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A client is receiving furosemide (Lasix). What electrolyte imbalance is the nurse most likely to monitor for?
A client is receiving furosemide (Lasix). What electrolyte imbalance is the nurse most likely to monitor for?
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A client with congestive heart failure gains 5 pounds in 1 week. What is the most likely fluid weight gain?
A client with congestive heart failure gains 5 pounds in 1 week. What is the most likely fluid weight gain?
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Before administering spironolactone, what medication is important to ask about?
Before administering spironolactone, what medication is important to ask about?
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Which of the following statements about aldosterone is true?
Which of the following statements about aldosterone is true?
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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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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.