KARCH PHARM Chapter 51 - Diuretic Agents

The class of diuretics that act to block the chloride pump in the distal convoluted tubules and leads to a loss of sodium and potassium and a minor loss of water is what?

A) Carbonic anhydrase inhibitors

B) Osmotic diuretics

C) Potassium-sparing diuretics

D) Thiazide diuretics

D

The nurse is providing discharge instructions to a 72-year-old patient who has been discharged home on a diuretic. What would the patient's instructions regarding the use of a diuretic at home include?

A) Measuring intake and output of urine

B) To weigh themselves on the same scale, at the same time of day, in the same clothing

C) Restrict fluids to 500 mL/d to limit the need to urinate

D) Decrease exercise to conserve energy

B

The emergency department (ED) nurse is caring for a patient who is experiencing pulmonary edema. The patient is treated with furosemide (Lasix). What will the nurse monitor?

A) Sodium levels

B) Bone narrow function

C) Calcium levels

D) Potassium levels

D

The nurse on the coronary unit is caring for a patient with known coronary artery disease who is being treated with cholestyramine (Questran) and hydrochlorothiazide (HydroDIURIL). What action will the nurse take?

A) Call the physician and refuse to give the drugs without further orders.

B) Make sure that the drugs are given at least 2 hours apart.

C) Give the patient an antacid with the drugs.

D) Check the patient's blood glucose level before giving the drugs.

B

The pharmacology instructor is discussing diuretic drugs with the nursing class. What would the instructor cite as an adverse effect of loop diuretics?

A) Hyperkalemia

B) Alkalosis

C) Hypertension

D) Hypercalcemia

B

A patient with glaucoma has been prescribed a diuretic as treatment of his or her disease process. What drug does the nurse suspect that the patient will be prescribed?

A) Acetazolamide (Diamox)

B) Spironolactone (Aldactone)

C) Chlorthalidone (Hygroton)

D) Bendroflumethiazide (Naturetin)

A

A patient comes to the clinic for a 1-month follow-up appointment. The patient tells the nurse he or she has been taking chlorothiazide (Diruil) for a month and now has leg cramps and "feels tired all the time." What will the nurse consider as the cause of the patient's symptoms?

A) Hypercalcemia

B) Hypocalcemia

C) Hyperkalemia

D) Hypokalemia

D

A patient has been prescribed furosemide (Lasix). Because this drug causes potassium loss, what will the nurse instruct the patient to eat?

A) Peaches

B) Apples

C) Pears

D) Pineapple

A

A 10-year-old child has edema caused by a heart defect. The patient is taking furosemide (Lasix). The dosage is 6 mg/kg/d. The child weighs 76 pounds. How many mg does the child receive in each dose?

A) 20 mg

B) 50 mg

C) 105 mg

D) 210 mg

D

The nurse is caring for a patient who is taking acetazolamide (Diamox) for treatment of glaucoma. What drug, if taken with acetazolamide (Diamox), would cause the nurse to contact the physician?

A) Indomethacin (Indocin)

B) Colestipol (Colestid)

C) Lithium (Eskalith)

D) Ibuprofen (Motrin)

C

A 68-year-old patient, who has type 1 diabetes, is to receive hydrochlorothiazide (HydroDIURIL). Before administration of this medication, what information is most important for the nurse to communicate to the patient?

A) His or her insulin dose may need to be increased.

B) His or he insulin dose may need to be decreased.

C)He or she will need to have him or her urine checked for ketones four times a day.

D) He or she will need to have a creatinine clearance done once a month.

A

When evaluating an 82-year-old patient receiving hydrochlorothiazide (HydroDIURIL), what laboratory value deviations may be related to the medication?

A) Elevated uric acid levels

B) Reduced blood urea nitrogen (BUN) levels

C) A serum potassium level of 4.7 mEq/L

D) A hemoglobin A1C of 4.8

A

What statement by the 62-year-old patient indicates that the patient understand the nurse's teaching about diuretics?

A) "I will weigh myself daily and report significant changes."

B) "I will have to limit my high sugar foods."

C) "If my leg gets swollen again, I'll take an additional pill."

D) "I will take my medication before bedtime on an empty stomach."

A

The nurse is providing discharge instruction to a patient who has just begun using diuretics. The nurse counsels the patient that it is most important to monitor the intake of foods that contain which element?

A) Calcium

B) Potassium

C) Glucose

D) Magnesium

B

The nurse is talking with a group of nursing students. What drug would the nurse tell them, when combined with furosemide (Lasix), is likely to cause hearing loss?

A) Codeine

B) Ciprofloxacin (Cipro)

C) Digoxin (Lanoxin)

D) Gentamicin (Garamycin)

D

A student asks the pharmacy instructor what the difference is between the diuretics spironolactone (Aldactone) and furosemide (Lasix). What would the instructor reply?

A) Potassium losses are lower with spironolactone.

B) Potassium losses are greater with spironolactone.

C) Water losses are greater with spironolactone.

D) Sodium losses are greater with spironolactone.

A

The nurse is caring for a patient with a severe head injury. An osmotic diuretic is ordered. The nurse understands which drug is an osmotic diuretic?

A) Spironolactone (Aldactone)

B) Bumetanide (Bumex)

C) Mannitol (Osmitrol)

D) Ethacrynic (Edecrin)

C

The staff educator in the ICU is talking with a group of new nurses about osmotic diuretics. The educator would tell the new nurses that osmotic diuretics act on which site in the nephron?

A) Proximal tubule

B) Glomerulus

C) Ascending limb of loop of Henle

D) Collecting tubule

B

A 64-year-old patient in hypertensive crisis is to receive furosemide (Lasix) 40 mg IV. Lasix comes in 100 mg/10 mL containers. How will the nurse administer the medication?

A) Give 4 mL over 1 to 2 minutes IV.

B) Give 4 mL over 10 minutes.

C) Flush the line with normal saline, give 1 mL/min, flush again when finished.

D) Fix 10 mL in an IV piggyback and deliver it over 30 minutes.

A

A 91-year-old patient is being discharged on the diuretic spironolactone (Aldactone). What is the major adverse effect of this type of medication?

A) Hypokalemia

B) Hyperkalemia

C) Gastric irritation

D) Hypertension

B

The nurse is conducting an admission assessment of a patient who has been prescribed hydrochlorothiazide (HydroDIURIL). Which situation would contraindicate the administration of hydrochlorothiazide (HydroDIURIL)?

A) Allergy to sulfa drugs

B) Allergy to codeine

C) BP 160/96

D) Blood glucose level of 140 mg/dL

A

The nurse is caring for a patient who has just been diagnosed with essential hypertension. The nurse is aware that the health care provider will begin therapy with which classification of diuretics?

A) Loop diuretics

B) Carbonic anhydrous inhibitors

C) Thiazide and thiazide-like diuretics

D) potassium-sparing diuretics

C

A female patient has a history of frequent bladder infections. Which classification of diuretic would not be recommended for this patient?

A) Thiazide and thiazide-like diuretics

B) Loop diuretics

C) potassium-sparing diuretics

D) Osmotic diuretics

A

What is the term for the action of a diuretic in a patient with glaucoma?

A) Intraocular pressure (IOP)

B) Osmotic pull

C) Diuresis

D) Potassium sparing

B

A patient has just begun to take a prescribed diuretic. Why would the nurse tell the patient to drink 8 to 10 glasses of water daily (unless it is counterindicated)?

A) To decrease the action of the renin-angiotensin cycle

B) To make more concentrated plasma

C) To dilute the urine

D) To avoid rebound edema

D

A patient has just been prescribed furosemide (Lasix). After reviewing the patient's medication history, what drug would cause the nurse concern when taken with furosemide (Lasix)?

A) Acetaminophen

B) Ferrous sulfate (Feosol)

C) Naproxen sodium (Naprosyn)

D) Ampicillin

C

A patient with glaucoma has been prescribed acetazolamide (Diamox). What adverse effects would the nurse caution the patient about? (Select all that apply.)

A) Paresthesia

B) Confusion

C) Drowsiness

D) Vomiting

E) Hyperkalemia

A,B,C

A patient who was recently prescribed spironolactone calls the clinic and complains that he is not urinating as much as he did when he first started taking this medication. What would be an appropriate question for the nurse to ask this patient?

A) "Are you taking a salicylate?"

B) "Are you taking acetaminophen?"

C) "Are you taking ibuprofen?"

D) "Are you using a lot of salt?"

A

The nurse is writing a plan of care for a patient who is taking a diuretic. What would be an appropriate nursing diagnosis for this patient?

A) Impaired urinary elimination

B) Monitor the patient response to the drug

C) Imbalanced nutrition: More than body requirements

D) Risk for fluid volume overload

A

A patient has been prescribed hydrochlorothiazide (HydroDIURIL) and the nurse is preparing to give the patient discharge instructions. Which adverse effects may this patient experience while taking this medication? (Select all that apply.)

A) Constipation

B) Dizziness

C) Polyphagia

D) Nocturia

E) Muscle cramps

B,D,E

A patient has just begun therapy with furosemide (Lasix), and the nurse is instructing the patient about the need to include foods high in potassium in the diet. Which foods would be appropriate for this patient to choose? (Select all that apply.)

A) Prunes

B) Apples

C) Watermelon

D) Lima beans

E) Rice

A,C,D

A nursing instructor is teaching a group of students about loop diuretics. Which would be included in this classification? (Select all that apply.)

A) Acetazolamide

B) Torsemide

C) Ethacrynic acid

D) Mannitol

E) Bumetanide

B,C,E

The nurse is caring for a patient with edema who has just begun taking a diuretic. What will the nurse use to evaluate the effectiveness of this medication? (Select all that apply.)

A) Daily weight

B) Decrease in edema

C) Increase in blood pressure

D) Increase in urinary output

E) Increase in pulse

A,B,D

The nurse has just administered 150 g of mannitol IV to a patient with increased intracranial pressure. What is most important for the nurse to monitor in the hour after administration?

A) Weight of patient

B) Blood pressure of patient

C) Pulse of patient

D) Respiratory rate of patient

B