Diuretics - week 3

week 3

what are the 3 different types of diuretics?

loop, thiazide, potassium-sparing

diuretic indication (6)

HF, edema, HTN, chronic kidney disease, liver failure, pulmonary edema

what is the suffix for loop diuretics?

-mide/nide

how does loop and thiazide diuretics decrease fluid retention?

inhibits reabsorption of sodium and chloride into the cells

what is the most potent diuretic?

loop - because they act on many parts of the kidney

what classes are potassium wasting diuretics?

loop and thiazide

what are the NRSG considerations for loop diuretics?

monitor potassium levels, weight pt daily, monitor fluid intake and output and electrolytes, administer in the morning, monitor BP

thiazide suffix

-thiazide

thiazide should not be administered to patients with what condition?

gout - this is because the medication may cause an increase of uric acid, which is the main cause of gout

sulfa allergy

what is an example of potassium-sparing diuretics?

spironolactone

what should a nurse monitor in a pt taking spironolactone?

high potassium

when is osmotic diuretics used

to decrease swelling and pressure in the eyes and brain

how is osmotic diuretics administered?

IV

when during a day should diuretics be taken ?

in the morning

what kind of diet should a pt be on if they are taking diuretics?

low sodium diet

what should be monitored for all pt on diuretics?

daily weights (report if pt gains 2lbs in 24 hrs)

intake and output

potassium levels

what is normal K+ levels

3.5-5.0

what are the 3 roles of the kidneys in homeostasis?

fluid balance

electrolyte balance

acid-base balance

what are the common adverse effects of diuretic therapy?

electrolyte imbalances, dehydration, hypotension

is it normal to combine 2 or more diuretic drugs?

yes

what is the most effective diuretic?

loop diuretic

what is the primary indications of furosemide?

edema and HTN

what are the 2 different routes of administration of loop diuretics?

IV and PO

what is an example of a loop diuretic?

furosemide

contraindications of loop diuretics

anuria (renal failure), hepatic coma, fluid/electrolyte depletion, sulfa allergy

whar is the pregnancy category of loop diuretics

category C

loop diuretics interact with what medications?

digoxin, lithium, sulfonylureas, insulin, NSAIDs, antihypertensives

why is it important to administer diuretics in the morning?

so that you ned to pee throughout the day, not all throughout the night

What electrolyte levels must be carefully observed while a person is on loop diuretics?

potassium

what age of patient must be carefully observed when on loop diuretics?

older adults

what vital signs must be carefully monitored?

HR, heart rhythm and BP

what drugs are similar to furosemide?

bumetanide, ethacrynic acid, torsemide

when is ethacrynic acid used?

pt allergic to sulfa drugs

what drug that is similar to furosemide causes severe hearing loss?

ethacrynic acid

what is the most commonly prescribed class of diuretic?

thiazide diuretics

what class of diuretic is the first line of treatment for primary hypertension?

thiazide diuretics

what adverse effect occurs for loop diuretics, but not thiazide diuretics?

ototoxicity

what are the 3 primary indications for thiazide diuretics?

HTN, HF, edema

what class is the drug HCTZ

thiazide

primary indication of loop diuretics

HTN, HF, pulmonary edema, liver disease, kidney disease

Side effects of loop diuretics

dehydration, electrolyte imbalances (hypokalemia and hyponatremia), hypotension, ototoxicity, hyperglycemia and rash

pt education for loop diuretics

move slowly (due to low BP), eat potassium rich foods, daily weights

what are the side effects of thiazide diuretics?

dehydration, hypokalemia (watch the heart), hyponatremia

potassium sparing diuretics indications

HF and HTN

potassium sparing diuretic contraindications

severe kidney failure

what are the key side effects of potassium sparing diuretics?

hyperkalemia, amenorrhea (lack of menstruation), gynecomastia and impotence

NRSG consierdations for potassium sparing diuretics

monitor potassium levels, avoid salt substitutes (these are high in potassium)