Exam (elaborations)
NUR2060 cardiac unit (1).
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NUR2060 cardiac unit (1).
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NUR2060 cardiac unitLoop Diuretics - ANS-furosemide (Lasix), bumetanide, torsemide (demadex)
Effects of loop diuretics - ANS--Blocks Na and K reabsorption at loop of henle.
-Increase renal blood flow
-MOST POWERFUL! (Most urine output)
-Works best on patients with urine output <30ml/hr
Uses of loop diuretics - ANS-Heart failure, liver disease, pulmonary edema, HYPERTENSION,
ascites (fluid on body), Oliguria (small urine production)
Loop diuretics can be administered... - ANS--IV: takes effect in about 5 mins
-PO: takes effect in about 1 hour
Loop diuretic ADR's - ANS--Fluid/electrolyte imbalance
-Hearing loss when administered too quickly
Loop diuretic drug interactions - ANS-Aminoglycoside antibiotics (ex gentamycin): hearing loss-
CAN BE PERMANENT
Loop diuretic nursing implications - ANS--Deliver IV Loops NO FASTER than 20-40mg/min
(CAUSES HEARING LOSS)
-Teaching patients best time to take, signs of hypokalemia, signs of hypotension
-dangerous in pregnancy/breastfeeding, use caution in elderly.
-monitor weight
Signs of hypokalemia - ANS-weakness, dysrhymias, dizziness, thirst, confusion, slow bowel
Signs of hyperkalemia - ANS-Weakness, paralysis, VFib, death.
normal potassium levels - ANS-3.5-5.0 mEq/L
-Too low: IV piggy back (IVPB) 10mEq in 50cc in D5W over 1 hour
(DO NOT PUSH. DEATH!)
-Too high: remove K+ with insulin and glucose in emergency
Can administer Kayexalate (stays in intestines and absorbs K+)
Thiazide diuretics (#1 for HTN!) - ANS-Hydrochlorothiazide (HCTZ, Hydrodiuril) metolazone
(Diulo, Zaroloxyn)
, Effects of thiazide diuretics - ANS-Increase excretion of salt, water, and potassium
Acts in distal tube
Antihypertensives- decreases peripheral vascular resistance
Uses of thiazide diuretics - ANS--HTN/Heart failure
-edema
-liver disease (cirrhosis)
-works best if urine output still >30cc/hr
-increases other HTN med effectiveness by 30-50%
Thiazides can be administered... - ANS--PO (takes 1 month to see full effect)
Thiazide ADR's - ANS--electrolyte imbalance
-increased fasting blood glucose levels
-elevated BUN
-elevated uric acid levels (hyperuricemia)
-increased serum cholesterol, triglycerides, and LDL
Thiazide nursing implications - ANS-Diet, timing of doses, take with meals
(Can be given every other day to avoid imbalances)
Thiazide drug interactions - ANS-digoxin and lithium
NSAIDs
Potassium sparing diuretics - ANS-Spironolactone (Aldactone) and triamterene (Dyrenium)
Effects receptors
Potassium sparing diuretic Spirinolactone (Aldosterone antagonist) effects - ANS-No selective
blocker acting in the distal nephron (takes effect in 1-2 days)
Promotes more sodium retention, gets rid of potassium
Blocks aldosterone in kidneys and cardiovascular areas
Used for HTN, Edema, heart failure, acne, PCOS
Potassium sparing diuretic uses - ANS-Edema, hypertension, heart failure, and counteracting
potassium loss with other diuretics
RARELY used alone- usually paired with a loop diuretic to help prevent hypokalemia
Potassium sparing diuretics can be administered... - ANS-PO
Potassium sparing diuretic ADR's - ANS-Hyperkalemia!
Hair growth
Menstrual issues
Potassium sparing diuretic drug interactions - ANS-ACE inhibitors
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