Summary
Summary NUR 210 Exam 3 Study Guide
- Course
- Galen NUR 210
- Institution
- Galen College Of Nursing
This is a comprehensive and detailed study guide on Exam 3 for Nur 210. *Essential Study Material!!
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Pharm class 11/11/2022Diuretics
Chapter 41
Diuretics: medications that promote the elimination of salt and water from the body.
Type of Diuretics:
1. Carbonic anhydrase
2. Thiazides (Hydrochlorothiazide or HCTZ)
3. Loop Diuretics (Furosemide, Lasik)
4. Osmotic (mannitol)
5. Potassium Sparing (Spirinolactone)
Hydrochlorothiazide (HCTZ)
How they work: They block Reabsorption of sodium, chloride, and water at the Distal
convoluted Tubule; they also increase the excretion of potassium/magnesium
,Uses: HTN, Edema
S/E+ADR:
Fluid and Electrolyte imbalances: Dehydration, hypokalemia, hypomagnesemia, hyponatremia
and orthostatic hypotension/ Dizzy, headache, weakness (probably comes from the low
potassium it causes muscle weakness), GI distress, photosensitivity, gout (increase of Uric Acid)
Contraindications: in Pregnancy, avoided in pts with Gout and if they are taking lithium (when
taking lithium stay hydrated).
Interactions: increases the risk for dig toxicity with hypokalemia; Steroids can exacerbate the
loss of potassium and decrease effects of antidiabetics
Loop Diuretics (Furosemide)
Action: Blocks Reabsorption of Sodium, chloride, and water at ascending loop. Also increase
excretion of potassium, magnesium, and calcium. Causes RAPID Diuresis.
Uses: Pulmonary edema, Heart failure, Cirrhosis (they help with ascites), Kidney Disease, HTN.
S/E+ADR:
Fluid and Electrolyte Imbalances: Dehydration, hypotension, hyponatremia, hypokalemia,
hypomagnesemia, hypocalcemia (remember all the Hypos) when your MAG and your
POTASSIUM go down, your patient can experience life-threatening arrhythmias (CODE BLUE)
PUSH 20 MG/MIN – PUSH SLOWLY!
Other S/E (continued): Ototoxicity (toxicity to the auditory nerve, leading to hearing loss and
tinnitus- happens when you push too fast), hyperglycemia, and rash.
Administration: before 5 pm if possible; when given IV administer slowly 20 mg/min
Contraindications: Pregnancy, avoid in Gout and patients taking Lithium; avoid giving in patients
with severe electrolyte imbalances; avoid in pts with an allergy to Sulfa drugs
Interactions: Anticoagulants (if taking both it can increase bleeding); steroids )increase in loss of
potassium); Dig toxicity with hypokalemia
Thiazides/Loop- wasting:
Signs and symptoms of Hypokalemia:
, Skeletal and muscle weakness; U-waves (EKG changes); Constipation/cramping; Toxicity (Dig);
Irregular pulse; Orthostatic Hypotension; Numbness/tingling. Remember SUCTION
Because of orthostatic hypotension and skeletal muscle weakness – fall risk
U-waves/Irregular pulse – arrhythmias
Cramping – teach pt to report
Potassium wasting Diuretics/Teaching and nursing actions:
Give it slowly if through IV (furosemide)
Record Daily Weight (1L = 1kg of body weight)
Monitor electrolytes, especially potassium
Encourage pt to eat high-potassium foods (green leafy veggies, bananas, avocados,
citrus, etc)
Replace potassium if low (either oral or IV, if giving pills cannot be crushed or cut they
are long-lasting)
Monitor BP
Teach pt to switch positions slowly
Osmotic Diuretics (Mannitol):
Action: Site is entire tubule, but major effects are in the PCT and descending loop; it inhibits
water reabsorption (means its not going back into the blood, its going out in the urine, the
patients losing free water called aquaresis)
Uses: Cerebral edema, it decreases ICP and IOP after eye surgery
Administration: can only be given IV for systemic effect and usually only given in Emergency
Settings.
S/E+ ADR:
Can cause pulmonary edema (only when given in high doses or if pt has pre-existing kidney
failure), can cause tachycardia because of fluid loss, metabolic acidosis, and acute kidney Injury
(AKI)
Contraindications: anuria, severe hypovolemia (dehydration), and pulmonary edema
Potassium sparing Diuretic/ Spirinolactone
Action: Blocks aldosterone. Collecting duct is main site of action of aldosterone (aldosterone is
responsible for sodium/water retention, and potassium excretion)
Effects: salt and water excretion, retains potassium
Uses: Heart failure, hypertension, cirrhosis
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