DIURETICS

Give Potassium-Wasting Diuretics (Loops/Thiazides) : Fluid overload (HF, edema, pulmonary edema), hypertension, normal potassium level.

Hold Potassium-Wasting Diuretics : Potassium < 3.5, dehydration, low blood pressure, no urine output (<30 mL/hr), digoxin toxicity risk.

Loop Diuretics (Lasix) Indications : Acute heart failure, pulmonary edema, crackles, high blood pressure, pink frothy sputum.

Thiazide Diuretics Indications : Hypertension (first-line), mild edema.

When to Give Potassium-Sparing Diuretics (Spironolactone) : Hypertension, heart failure, low potassium, used with potassium-wasting meds to balance K⁺.

Hold Potassium-Sparing Diuretics : Potassium > 5.0, renal failure, taking ACE inhibitors or ARBs (risk of hyperkalemia).

Check Before Giving Any Diuretic : Blood pressure (hold if systolic < 90), potassium level, kidney function (BUN/Cr), urine output.

Give All Diuretics Timing : Morning—to prevent nocturia.

Monitoring After Giving Diuretics : Daily weight, I&O, BP, edema, potassium, lung sounds.

Potassium-Wasting Diuretics Examples : Furosemide (Lasix), Bumetanide, Hydrochlorothiazide (HCTZ).

Potassium-Sparing Diuretics Examples : Spironolactone, Eplerenone.

Low Potassium + Diuretics : Only give if provider also orders potassium replacement.

High Potassium + Diuretics : Do NOT give potassium-sparing drugs.

Heart Failure Priority Diuretic : Loop diuretics—fastest acting.

Renal Failure Concern : Hold all diuretics if no urine output (<30 mL/hr).