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What is the drug classification for:
furosemide (Lasix)
bumetanide (Bumex)
- High-Ceiling Loop Diuretic that acts on the Loop of henle:
- ---blocking the reabsorption of Na and Cl + preventing reabsorption of water
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What are Loop diuretics used for?
needed when there is an emergent need for rapid mobilization of fluid
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Which diuretic would you use on a patient suffering from:
--pulmonary edema caused by Heart Failure
--edema caused by Liver, Cardiac, or Kidney Disease or HTN
--hypercalcemia r/t kidney stone formation
- Furosemide (Lasix)
- Bumetanide (Bumex)
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What adverse effects would a nurse monitor on a patient taking furosemide (Lasix)?
- dehydration
- hyponnatremia
- hypotension
- hypokalemia
- ototoxicity
- hyperglycemia
- hyperuricemia
- hypocalcemia
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What are the signs and symptoms of Dehydration that a nurse would monitor for on a patient taking furosemide to treat heart failure or edema
- dry mouth
- increased thirst
- urine output less than 30ml/hr
- weight loss
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What signs/symptoms would a nurse monitor on a patient taking furosemide for an indication of Thrombosis or Embolism?
- Headache
- chest pain
- calf pain
- pelvic pain
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Starting patients on a low dose of Lasix and monitoring the patients daily weight would help minimize
the risk for dehydration
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Light headedness and dizziness are both signs of what?
postural hypotension
(advise your patient to sit or lie down)
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Why would a nurse advise a client to avoid sudden changes of position or to rise slowly from lying down or sitting?
To prevent hypotension esp orthostatic hypotension
(monitor clients Blood Pressure)
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A nurse would advise his patient who is taking furosemide, a loop diuretic to notify the health care provider if he experiences what symptom?
tinnitus, ringing in the ears, which may indicate ototoxicity.
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What would the nurse teach a patient who takes furosemide daily + has a potassium level of 3.3.
Teach the patient to consume high potassium foods
(bananas, orange juice, spinach, nuts)
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What signs would a nurse monitor for a patient suspected of having hypokalemia?
- nausea
- vomiting
- general weakness
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Why would a nurse monitor uric acid levels on a patient taking Lasix?
Lasix is a loop diuretic which causes an increase in uric acid levels
(be cautious with a patient who has gout)
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What would the nurse monitor a patient who is taking digoxin (cardiac glycoside) and furosemide (diuretic) for?
Ventricular dyshythmias which occurs in the presence of hypokalemia
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A nurse would monitor a patient with hyponatremia (due to a loop diuretic) for
Lithium Toxicity
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What signs would a nurse monitor on a patient suspected of having low levels of magnesium?
- weakness
- muscle twitching
- tremors
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weight loss, light headedness, dizziness, GI distress, and general weakness are s/s that indicate?
Hypokalemia or Hypovolemia
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What signs would alert the nurse that the medication is effective with a patient taking Lasix to treat heart failure?
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-decrease in pulmonary or peripheral edema
- -weight loss
- -decrease in BP
- -Increase in Urine output
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What is the drug classification for spironolactone (aldactone)
potassium-sparing diuretic
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What is purpose or expected outcome of Aldactone (spironolactone)
1. blocks the action of aldosterone by excreting sodium and water
2. retains potassium in the blood
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A potassium-sparing diuretic is given to a patient with
heart failure
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How long would the therapeutic effect take on a patient who is taking a potassium-sparing diuretic?
12 to 48 hours
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What are the adverse effects of potassium-sparing diuretic?
- Hyperkalemia
- male impotence
- irregularities of menstrual cycle (females)
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What patient teaching would a nurse include on a patient taking a potassium-sparing diuretic?
To avoid using salt substitutes b/c it is high in potassium which could cause hyperkalemia, potassium serum levels > 5.0
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What diuretic has no risk of hearing loss and can be combined with ototoxic medications?
Thiazide diuretic
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What would the nurse teach a patient taking a thiazide diuretic, who complains of having GI upsets?
To take medication with meals or after meals
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The nurse would know that the Thiazide diuretic medication was effective if
The patient shows a
- -decrease in BP + edema
- -increase in urine output
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A nurse would Hold the potassium-sparing diuretic medication on a patient who
Has hypokalemia or has severe kidney failure?
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A patient who is taking ACE inhibitors concurrently with potassium-sparing diuretic, or while taking potassium supplements
increase the patients risk of hyperkalemia
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Effectiveness of a potassium-sparing diuretic medication is evident if the patient shows signs of
- normal potassium serum levels of 3.5-5.0
- weight loss
- decrease of BP + edema
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