HFHS Orientation - F+Es PDF

# Agents for Fluid and Electrolyte Balance ## A. Diuretics - Thiazides: Hydrochlorothiazide (Hydrodiuril), Chlorthalidone (Hydrodiuril) - Loop diuretics: Furosemide (Lasix), Bumetanide (Bumex), Ethacrynic acid (Edecrin) - Potassium sparing diuretics: Spironolactone (Aldactone), Amiloride (Midador)...

# Agents for Fluid and Electrolyte Balance ## A. Diuretics - Thiazides: Hydrochlorothiazide (Hydrodiuril), Chlorthalidone (Hydrodiuril) - Loop diuretics: Furosemide (Lasix), Bumetanide (Bumex), Ethacrynic acid (Edecrin) - Potassium sparing diuretics: Spironolactone (Aldactone), Amiloride (Midador) ### 1. Indications - Used to treat edema in CHF; hepatic or renal disease; & hypertension by increasing water and sodium excretion. ### 2. General Nursing Considerations - Monitor electrolytes - May need to increase potassium intake with thiazides and loop diuretics. Encourage foods rich in potassium. - Warn patient to contact their physician immediately for any of these side effects: irregular heartbeat, skin rashes, unusual bruising, ringing in the ears, irreversible hearing loss, or jaundice. - For patients taking potassium-sparing diuretics, you must monitor for hyperkalemia and instruct the patient to avoid foods and salt substitutes that are high in potassium. ## B. Electrolytes ### 1. General Information - Concentrated IV electrolyte solutions are considered High Alert Medications. ### 2. Potassium Supplements - Potassium Chloride (KCL), Oral - K-Dur, Slow K (Extended release). Do not crush #### a. Indications: - To return and/or maintain the patient's potassium level within normal limits. #### b. Nursing Considerations: - IV by infusion only, never IV push. Maximal infusion rate 20 mEq/hour. Can cause cardiac arrest if infused too fast. - Monitor for signs of hyperkalemia: cardiac arrhythmia, heart block, ECG changes - Monitor for signs of decreased kidney function, such as decreased urine output (since kidneys excrete potassium, this usually leads to an increased potassium level). ### 3. Magnesium Supplements - Magnesium gluconate, Magnesium sulfate #### a. Indications: - To return and/or maintain the patient's magnesium level within normal limits. #### b. Nursing Considerations: - Use with caution in renal disease, especially when administered intravenously. - Excessive oral doses can cause diarrhea and GI irritation. - Geriatrics require reduced doses because of renal dysfunction. - Monitor serum magnesium levels and clinical status to avoid overdose. - Monitor IV sites for extravasation.