Term
| Diuretics are used for two main purposes: |
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Definition
| to decrease hypertension (lower blood pressure) and to decrease edema |
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Term
| an elevated blood pressure |
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Definition
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Term
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Definition
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Term
| Most sodium and water reabsorption occurs throughout which of the renal tubular segments |
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Definition
| proximal, loop of Henle [descending loop and ascending loop], and collecting tubule |
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Term
| smotic, mercurial, and carbonic anhydrase inhibitor diuretics affect the ___ ____ |
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Definition
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Term
| oop (high-ceiling) diuretics affect the _____ ___ _____ |
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Definition
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Term
| thiazides affect the ____ _____ |
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Definition
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Term
| potassium-sparing diuretics act primarily on the |
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Definition
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Term
| Diuretics have an _________ effect because they promote sodium and water loss by blocking sodium and chloride reabsorption. |
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Definition
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Term
| fluid retention in body tissues |
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Definition
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Term
| With fluid loss, edema (fluid retention in body tissues) should decrease, but if sodium is retained, water is also _____, and blood pressure ______. |
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Definition
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Term
| . The diuretics that promote potassium excretion are classified as |
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Definition
| potassium-wasting diuretics, and those that promote potassium retention are called potassium-sparing diuretics. |
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Term
| five categories of diuretics are effective in removing water and sodium: |
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Definition
Thiazide and thiazide-like
• Loop or high-ceiling
• Osmotic
• Carbonic anhydrase inhibitor
• Potassium-sparing |
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Term
| Except for those in the potassium-______ group, all diuretics are potassium-______. |
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Definition
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Term
| Thiazides act on the___ ____ ___ tubule, beyond the loop of Henle, to promote sodium, chloride, and water excretion. |
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Definition
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Term
| _______ are used to treat hypertension and peripheral edema. They are not effective for immediate diuresis and should not be used to promote fluid loss in clients with severe renal dysfunction. |
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Definition
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Term
| If the client has a renal disorder and creatinine clearance is less than _____mL/min, the effectiveness of the thiazide diuretic is greatly decreased. |
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Definition
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Term
| Thiazides cause a loss of sodium, potassium, and magnesium, but they promote ______reabsorption |
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Definition
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Term
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Definition
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Term
| Thiazides affect glucose tolerance, so _______can also occur. |
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Definition
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Term
| ________ has been combined with selected angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, alpha-blockers, angiotensin II blockers, and centrally acting sympatholytics to control hypertension. |
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Definition
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Term
| Thiazides act directly on arterioles to cause ______, which can lower blood pressure |
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Definition
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Term
| Side effects of thiazides include |
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Definition
| electrolyte imbalances (hypokalemia, hypercalcemia, hypomagnesemia, and bicarbonate loss), hyperglycemia (elevated blood sugar), hyperuricemia (elevated serum uric acid level), and hyperlipidemia (elevated blood lipid level). |
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Term
| Thiazides can increase serum ___, ____, and ____ levels |
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Definition
| cholesterol, low-density lipoprotein, and triglyceride |
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Term
| marked decrease in urine output |
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Definition
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Term
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Definition
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Term
| Symptoms of severe kidney impairment or shutdown include : |
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Definition
| oliguria (marked decrease in urine output), elevated blood urea nitrogen (BUN), and elevated serum creatinine. |
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Term
| Of the numerous thiazide drug interactions, the most serious occurs with digoxin. Thiazides can cause ________ which enhances the action of digoxin, and digitalis toxicity can occur. |
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Definition
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Term
| Thiazides enhance the action of ______ |
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Definition
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Term
| Thiazides potentiate the action of other _______ drugs, which may be used to advantage in combination drug therapy for hypertension. |
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Definition
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Term
| Thiazide diuretic contrandications |
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Definition
| Renal failure with anuria, electrolyte depletion |
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Term
| _____ ______ can increase renal blood flow up to 40%. |
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Definition
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Term
| Loop diuretics cause excretion of calcium, unlike ______, which inhibit calcium loss. |
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Definition
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Term
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Definition
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Definition
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Term
| Loop diuretics have a great saluretic (sodium-chloride–losing) or natriuretic (sodium-losing) effect and can cause rapid diuresis, _______vascular fluid volume and causing a ______ in cardiac output and blood pressure. |
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Definition
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Term
| he most common side effects of loop diuretics are |
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Definition
| fluid and electrolyte imbalances such as hypokalemia, hyponatremia, hypocalcemia, hypomagnesemia, and hypochloremia. |
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Term
| ____ _____ increase the osmolality (concentration) and sodium reabsorption in the proximal tubule and loop of Henle. |
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Definition
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Term
| This group of drugs is used to prevent kidney failure, to decrease intracranial pressure (ICP) (e.g., in cerebral edema), and to decrease intraocular pressure (IOP) (e.g., in glaucoma). |
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Definition
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Term
| ______ is a potent osmotic potassium-wasting diuretic frequently used in emergency situations such as ICP and IOP. |
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Definition
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Term
| Mannitol must be given with extreme caution to clients who have _____ and _____ |
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Definition
| heart disease and HF. It should be immediately discontinued if the client develops HF or renal failure. |
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Term
| Note client's weight to determine fluid loss or gain. A loss of 2.2 pounds is equivalent to a fluid loss of |
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Definition
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Term
| the enzyme ____ ____, which is needed to maintain the body's acid-base balance (hydrogen and bicarbonate ion balance). |
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Definition
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Term
| This group of drugs is used primarily to decrease IOP in clients with open-angle (chronic) glaucoma. These drugs are not used in narrow-angle or acute glaucoma. |
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Definition
| Carbonic Anhydrase Inhibitors |
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Term
| Carbonic Anhydrase Inhibitors side effects: |
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Definition
| e fluid and electrolyte imbalance, metabolic acidosis, nausea, vomiting, anorexia, confusion, orthostatic hypotension, and crystalluria |
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Term
| _____ _____ diuretics, which are weaker than thiazides and loop diuretics, are used as mild diuretics or in combination with another diuretic (e.g., hydrochlorothiazide or antihypertensive drugs). |
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Definition
| Potassium-Sparing Diuretics |
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Term
| _____ _____ diuretics act primarily in the collecting duct renal tubules and late distal tubule to promote sodium and water excretion and potassium retention. |
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Definition
| Potassium-sparing diuretics |
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Term
| otassium-sparing diuretics are used alone, they are less effective than when used in combination to reduce body fluid and sodium. These drugs are usually combined with a _____ _____ diuretic, primarily hydrochlorothiazide or a loop diuretic. |
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Definition
potassium-wasting diuretic
The combination of potassium-sparing and potassium-wasting diuretics intensifies the diuretic effect and prevents potassium loss |
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Term
| side effect of potassium sparing diuretic: |
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Definition
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Term
| If a potassium-sparing diuretic is given with antihypertensive ____ ____, hyperkalemia could become severe or life-threatening, because both drugs retain potassium. |
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Definition
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Term
1. A client is taking hydrochlorothiazide 50 mg/day and digoxin 0.25 mg/day. What type of electrolyte imbalance does the nurse expect to occur?
a. Hypocalcemia
b. Hypokalemia
c. Hyperkalemia
d. Hypermagnesemia |
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Definition
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Term
2. What would cause the same client's electrolyte imbalance?
a. High dose of digoxin
b. Digoxin taken daily
c. Hydrochlorothiazide
d. Low dose of hydrochlorothiazide |
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Definition
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Term
3. A nurse is teaching a client who has diabetes mellitus and is taking hydrochlorothiazide 50 mg/day. The teaching should include the importance of monitoring which levels?
a. Hemoglobin and hematocrit
b. Blood urea nitrogen (BUN)
c. Arterial blood gases
d. Serum glucose (sugar) |
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Definition
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Term
4. A client has heart failure and is prescribed Lasix. The nurse is aware that furosemide (Lasix) is what kind of drug?
a. Thiazide diuretic
b. Osmotic diuretic
c. High-ceiling (loop) diuretic
d. Potassium-sparing diuretic |
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Definition
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Term
5. The nurse acknowledges that which condition could occur when taking furosemide?
a. Hypokalemia
b. Hyperkalemia
c. Hypoglycemia
d. Hypermagnesemia |
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Definition
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Term
6. For the client taking a diuretic, a combination such as triamterene and hydrochlorothiazide may be prescribed. The nurse realizes that this combination is ordered for which purpose?
a. To decrease the serum potassium level
b. To increase the serum potassium level
c. To decrease the glucose level
d. To increase the glucose level |
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Definition
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Term
7. The client has been receiving spironolactone (Aldactone) 50 mg/day for heart failure. The nurse should closely monitor the client for which condition?
a. Hypokalemia
b. Hyperkalemia
c. Hypoglycemia
d. Hypermagnesemia |
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Definition
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Term
8. A client who has angina is prescribed nitroglycerin. The nurse reviews which appropriate nursing interventions for nitroglycerin? (Select all that apply.)
a. Have client lie down when taking a nitroglycerin sublingual tablet.
b. Teach client to repeat taking a tablet in 5 minutes if chest pain persists.
c. Apply Transderm-Nitro patch to a hairy area to protect skin from burning.
d. Call the health care provider after taking 5 tablets if chest pain persists.
e. Warn client against ingesting alcohol while taking nitroglycerin. |
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Definition
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