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When assessing a patient who is receiving a loop diuretic, the nurse looks for the manifestations of potassium deficiency, which would include what symptoms? (Select all that apply.) a. Dyspnea
A patient receiving diuretics should alert the nurse if she feels the following: 4. What is the first loop diuretic introduced? 5. A patient admitted for cerebral swelling complained of feeling light-headed and nauseous while receiving mannitol.
Answer: A. Furosemide Furosemide was the first loop diuretic to be approved in the United States (1966) and is still widely used today. Ethacrynic acid was the second loop diuretic to be approved for use in the United States (1967), but is now rarely used.
A patient on diuretic therapy calls the clinic because he's had the flu, with "terrible vomiting and diarrhea," and he has not kept anything down for 2 days. He feels weak and extremely tired. Which statement by the nurse is correct? a. "It's important to try to stay on your prescribed medication. Try to take it with sips of water." b.
Clinicians should include periodic monitoring of blood pressures, fluid status (including weight), serum electrolytes, and renal function in continued diuretic treatments. Goals for diuresis should consist of dosage adjustments as patients progress with their response to the diuretics.
As a result, the loop diuretics are used more for the therapy of edema than long term therapy of hypertension. Common and shared side effects of the loop diuretics include dizziness, headache, gastrointestinal upset, hypernatremia, hypokalemia and dehydration.
Careful monitoring of the patient's clinical condition, daily weight, fluids intake, urine output, electrolytes, i.e., potassium and magnesium, kidney function monitoring with serum creatinine and serum blood urea nitrogen level is vital to monitor the response of furosemide.
Loop diuretics reduce sodium chloride reabsorption in the thick ascending limb of the loop of Henle. This is achieved by inhibiting the Na-K-2Cl carrier in the luminal membrane in this segment, thereby minimizing the entry of luminal sodium and chloride into the cell (figure 1) [1].
Loop diuretics also have the potential to cause ototoxicity and hearing loss. Of note hypokalemia can cause ventricular arrhythmias and muscular weakness. Spironolactone's primary adverse effect is hyperkalemia, especially in elderly patients and those with chronic kidney disease.
1:333:02How diuretics cause hypokalemia - YouTubeYouTubeStart of suggested clipEnd of suggested clipAnd makes the lumen more electronegative. And this in turn increases potassium secretion finallyMoreAnd makes the lumen more electronegative. And this in turn increases potassium secretion finally increased potassium loss causes hypokalemia. This is how loop diuretics cause hypokalemia.
This medication may cause dehydration and electrolyte imbalance. Tell your doctor right away if you have any of these unlikely but serious side effects: muscle cramps, weakness, unusual tiredness, confusion, severe dizziness, fainting, drowsiness, unusual dry mouth/thirst, nausea, vomiting, fast/irregular heartbeat.
The more common side effects that can occur with furosemide include:nausea or vomiting.diarrhea.constipation.stomach cramping.feeling like you or the room is spinning (vertigo)dizziness.headache.blurred vision.More items...
NSAIDs reduce the vasodilation and natriuretic effects of furosemide by inhibiting the synthesis of prostaglandins, resulting in Na+ retention, azotemia, and hyperkalemia25). Furosemide induces various electrolyte imbalances including hypokalemia, hypomagnesemia, hypocalcemia, hyponatremia, and hyperuricemia3,16).
How do loop diuretics work? They work by making the kidneys pass out more fluid. They do this by interfering with the transport of salt and water across certain cells in the kidneys. (These cells are in a structure called the loop of Henle - hence the name loop diuretic.
Diuretics help rid your body of sodium and water. Most work by making your kidneys release more sodium into the urine. The sodium then takes water with it from your blood decreasing the amount of fluid flowing through your blood vessels hence lowering blood pressure.
Loop diuretics were associated with a significantly higher prevalence of hypernatremia than no diuretic treatment (P = 0.0023). There was no significant difference for all other types of diuretic agent (P >0.05).
Caution must be exercised in the administration of diuretics to the older adults because they are more sensitive to the therapeutic effects of these drugs and are more sensitive to the adverse effects of diuretics , such as dehydration, electrolyte loss, dizziness, and syncope.
The loop diuretics have a rapid onset of action; therefore, they are useful when rapid onset is desired. Their effect lasts for about 2 hours, and a distinct advantage they have over thiazide diuretics is that their diuretic action continues even when creatinine clearance decreases below 25 mL/min.
ANS: B. An undesirable effect of carbonic anhydrase inhibitors is that they elevate the blood glucose level and cause glycosuria in diabetic patients. They induce metabolic acidosis, making their usefulness limited. In addition, hypokalemia and drowsiness may occur.
Orthostatic hypotension is a possible problem with diuretic therapy. Foods high in potassium should be eaten more often, and the drug needs to be taken in the morning so that the diuretic effects do not interfere with sleep. A weight gain of 5 pounds or more per week must be reported immediately.
The Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-8) guidelines reaffirmed the role of thiazide diuretics as one of the first-line treatment for hypertension. The other drug classes are not considered first-line treatments.
Diuretic agents are used in management of hypertension to reduce blood pressure by decreasing circulating fluid volume and sodium. Glaucoma is an eye disease that is characterized by increased intraocular pressure (IOP), which is the pressure inside the eyes.
Thiazide and Thiazide-like Diuretics. Thiazide diuretics belong to a chemical class of drugs called sulfonamides. Thiazide-like diuretics have different chemical structure but work in the same mechanism as that of thiazide diuretics. This is among the most commonly used class of diuretics.
Disease Spotlight: Edema, Hypertension, and Glaucoma. Edema is the accumulation of fluids in the interstitial spaces. It can be typically seen in patients with heart failure (HF), cirrhosis and other liver diseases, and renal diseases. Ed ema in HF is caused by activation of the renin-angiotensin system due to an inefficient pumping activity ...
Spironolactone acts as aldosterone antagonist which blocks the action of aldosterone in the distal tubule. On the other hand, amiloride and triamterene block potassium secretion through the tubule.
Administer intravenous diuretics slowly to prevent severe changes in fluid and electrolytes. Administer oral form early in the day to prevent increased urination during sleep hours. Monitor patient response to drugs through vital signs, weight, serum electrolytes and hydration to evaluate effectiveness of drug therapy.
It can produce a fluid loss up to 20 pounds per day. Proven to be effective even with the presence of acid-base disturbances, renal failure, electrolyte imbalances, and nitrogen retention. Also used in the treatment of pulmonary edema but its effect only influences the blood that reaches the nephrons.
Cirrhosis and other liver diseases present with edema because of two reasons: 1) reduced plasma protein production leading to decreased oncotic pressure (pressure that holds the fluid in); and 2) portal system obstruction due to hepatic vessel congestion.