Diuretics

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dsherman
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92382
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Diuretics
Updated:
2011-06-30 06:58:24
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Diuretics
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Diuretics
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  1. Diuretics
    • Uses: treat edema that involves fluid volume excess resulting from a number of disorders of the heart, liver, kidneys
    • Contraindications:
    • Pregnancy, breastfeeding
    • severe adrenocortical impairment
    • anuria (urine output of then 30 mL per/hr), progressive oliguria (urine output less then 300/500 mL per/day)
    • Precautions:
    • fluid and elecrtolyte depletion, gout
    • clients taking digitalis, lithium, nonsteroidal antiinflammatory drugs (NSAID's), and other antihypertensive medications
    • Side Effects:
    • dehydration
    • hyponatremia
    • hypochloremia
    • hypokalemia
    • unusual tiredness, weakness, dizziness
    • irregular heart beat, weak pulse, orthostatic hypotension
    • tinnitus
    • hyperglycemia
    • hearing loss (lasix)
    • Nursing implications:
    • monitor for adequate intake and outut and potassium loss
    • monitor client's weight and vital signs
    • monitor for signs and symptoms of hearing loss, which may last from 1 to 24 hours
    • teach client to take medication early in the day to decrease nocturia
    • teach client to report any hearing loss or signs of gout
  2. Mannitol (Osmitrol)
    • Classification: Osmotic diuretic
    • Action: increases the osmotic pressure of the glomerular filtrate. The higher the concentration of mennitol in the filtrate, the more diuresis occurs
    • Uses:
    • Prevents, treats oliguric phase of acute renal failure
    • reduces increased intracranial pressure caused by cerebral edema, decreases edema of injured spinal cord
    • decreases intraocular pressure caused by acute glaucoma
    • promotes excretion of toxic substances
    • Contraindications:
    • severe reanl disease
    • dehydration
    • intracranial bleeding
    • severe pulmonary edema
    • Precautions:
    • cardiac failure
    • pulmonary edema
    • Side effects:
    • blurred vision, dizziness, tachycardia, peripheral edema
    • headache, nausea and vomiting, backache
    • Nursing implications:
    • check vital signs before administering the dose
    • assess urinay output, hydration status, electrolytes (hypokalemia), blood urea nitrogen and renal and hepatic panels
    • evaluate for symptoms of congestive heart failure and pulmonary edema
    • intravenous (IV) medications may crystallize, need to warm to put into solution. Draw up medication with a filter needle and administer with an in-line filter to prevent any crystals from entering circulation
  3. Spironolaction (Aldactone)
    • Classification: Potassium-sparing diuretic
    • Action: competes with aldosterone for cell receptor sites in the distal tubules while inducing urinary excretion of sodium and reducing excretion of potassium and hydrogen ions
    • Uses:
    • treats hypertension and edema
    • reduces edema in clients with severe heart failure
    • Contraindications:
    • hypersensitivity or renal failure
    • anuria (non passage of urine, output of less then 30 mL per/hr)
    • hyperkalemia
    • Precautions:
    • renal dysfunction
    • Side effects:
    • hyperkalemia, hyponatremia
    • weakness
    • dehydration
    • hyperglycemia, hirsuitism (excessive hairiness), menstrual irregularities, gynecomastia (breast enlargement in men)
    • impotence, deepening of voice
    • Nursing implications:
    • monitor intake and output, and watch for cardiac dysrhythmias
    • monitor levels of electrolytes (e.g., potassium, sodium)
    • teach client to report cramps, weakness, fatigue, or nausea
  4. Furosemide (Lasix)
    • Furosemide (Lasix)
    • Classification: Loop Diuretic
    • Action: prevents the reabsorption of sodium and chloride in the loop of henle region of the nephron
    • Uses:
    • treatment of acute heart failure (because it has the ability to remove large amounts of fluid in a short period of time)
    • hypertension
    • edema
    • Contraindications:
    • hypokalemia
    • Percautions:
    • premature infants and neonates
    • geriatric patients may require lower doses
    • pregnancy category C
    • Side effects:
    • dehydration, hyponatremia, hypochloremia, hypokalemia
    • unusual tiredness, weakness, dizzinesss
    • irregular heart beat, weak pulse, orthostatic hypotension
    • tinnitus, hyperglycemia, hyperuricemia, hearing loss
    • Nursing indications:
    • monitor adequate intake and output and potassium loss
    • monitor client'a weight and vital signs
    • monitor for signs and symptoms of hearing loss, which may last from 1 to 24 hours
    • teach client to take medication early in the day to decrease nocturia
    • teach client to report any hearing loss or signs of gout

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