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Exam (elaborations) NUR 100 Study Guide for Pharmacology for Nursing Care - E-Book
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NUR 100 PHARMACOLOGY UNIT 3EXAM STUDY GUIDE
Mechanism of action for Loop diuretics? (furosemide, bumetanide, torsemide.) - Blocks Na+ &
C1-reabsorption along the ascending of loop of Henle (kidneys). Activates renal prostaglandins
which dilate the blood vessels of the kidneys, lungs and the rest of the body. Prevents passive
reabsorption of *water & potassium (so patient will loose water and potassium)
Mechanism of action for thiazide? (hydrochlorothiazide, chlorothiazide, metolazone, ) - Inhibits
Na+, K+, C1 reabsorption in the distal tubule of the nephron of *the kidneys are the site of action
for diuretics.
Not the maximum diuresis of loop diuretics. Not effective when GFR is low. (dependent on
adequate kidney function) * There must be proper kidney functioning for this med to work.
Mechanism of action for Potassium Sparing Diuretics? (*spironolactone, amiloride, triamterene)
- Works by blocking aldosterone receptors. This lowers reabsorption of Na+ & H20 and
*increases potassium level. Rarely used alone for diuresis. Combine with other diuretic.
Mechanism of action for osmotics? (mannitol ) - increases osmotic pressure of glomerular
filtrate, pulls water in to renal tubules. Inhibits passive reabsorption of H20. *Used only in head
trauma.
Indications for Loop diuretics? - *Rapid diuresis (critical situations)
Pulmonary edema (pink frothy sputum, fluid in lungs)
CHF, HTN, Renal failure, Cirrhosis, Ascites-fluid in the abd.
indications for osmotic diuretics? - *reducing ICP.
Renal failure, decreases intraocular pressure .
indications for thiazide diuretics? - *#1 choice for HTN
CHF-mild to moderate, *Diabetes insipidus (makes urine gravity like water) thiazide diuretics
decrease urine production by 30 to 50%
Promotes reabsorption of calcium; may decrease risk of osteoporosis in postmenopausal
women. *Still mechanism of action is unclear
indications for potassium sparing diuretics? - HTN, edema
*Hyperaldosteronism-(spironolactone med)
*polycystic ovarian syndrome-(spironolactone med)
, Reverse K+ loss
CHF
Characteristics of Loop diuretics? - onset: PO 30-60min, duration 6-8hours
IV 5-10min, duration 2hours
*Can be used in patients with severe renal impairment such as kidney failure.
Side effects and Nur Considerations with Loop diuretics? - side effects: Dizziness, Headache,
tinnitus, nausea, vomiting, and diarrhea. agranulocytosis, thrombocytopenia, neutropenia.
Decreases K+, Mag, Ca *hyperglycemia, dehydration, fluid and electrolytes loss. Pregnancy
category C.
Nur. Considerations: Hypokalemia , DOC for rapid effects *Lasix with aminoglycosides &
vancomycin *ototoxicity. Lithium-monitor level(0.5-1.5)
NSAIDS; other antihypertensives
increase risk of dig toxicity 0.5 to 2)
teaching foods high in K, daily weights (check weight same time of day with same scale).
Monitor BP, I&O, K+ (normal 3.5-5.0) Notify MD of output less than 30ml per hr. Report no
weight loss greater than 2lbs per day and greater than 5lbs per week. 1kg (2.2lb)= 1L fluid
gain/loss 24hr. *Iv Lasix give at a rate of 20mg/minute.
Rate of infusion for Lasix? - *Iv Lasix give at a rate of 20mg/minute
major side effects for thiazide and Nur. Considerations? - side effects: same as with loop
diuretics except no *ototoxicity. *Monitor electrolytes regularly. Monitor blood glucose as this will
increase. K+ decreases.
Nur. Considerations? HCTZ: frequently used as least *expensive. Increase risk of dig toxicity
because of hypokalemia-(low potassium)
Monitor K+ levels
Don't give at *bedtime after 5pm
Daily weights for the* elderly using loops & thiazides due to risk of dehydration, electrolyte loss,
dizziness, syncope. NSAIDs may blunt diuretic effects can give with aminoglycosides.
Potassium sparing Diuretics SE and NUR. considerations? - dizziness, headache, cramps,
nausea, vomiting, diarrhea, *hyperkalemia(high potassium levels), gynecomastia, * impotence,
menstrual irregularities, hirsutism, deep voice.
Nur,. Consid: Hyperkalemia Antidote *sodium polystyrene sulfonate *kayexalate
Potassium supplement, salt substitues, ACE inhibitors, ARBs, & direct renin inhibitors: increase
potassiums
Injection of insulin can lower k+.
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