Question

Nursing Actions Problem 1. A patient taking a loop diuretic complains of weakness and leg cramps. 2. A patient taking hydrochlorothiazide asks the nurse if the medication could possibly be affecting his blood glucose levels. He states, "My blood sugars are running higher than normal." 3. A patient on diuretic therapy calls the office because he has had a "terrible gastrointestinal flu" for 2 days. He has not been able to eat or drink, has had vomiting and diarrhea, and feels very weak and lethargic 4. A 45-year-old woman is taking a loop diuretic. She is used to being physically active and complains that she gets "very dizzy" when she stands up suddenly 5. A patient taking spironolactone tells the nurse that she eats three bananas a day and drinks "plenty of orange juice" because she knows that she needs to take potassium while on this medication.

Answer 1

1.

• loop diuretics increase excretion of electrolytes like sodium, chloride and potassium through urine causes leg cramps and weakness.
• check electrolyte level.
• increase sodium and potassium intake

2.

blood glucose level usually rises when serum potassium level gets reduced during hydrochlorothiazide treatment.so,

• advice to take potassium rich food like bananas.

3. these symptoms are due to congestion of the liver and the intestine or electrolyte and metabolic disturbances.

• administer the drug with food or milk to buffer drug effect.
• assess skin conditions to determine fluid deficit.

4.

• Assess cardiopulmonary status( blood pressure, pulse rate, heart and lung sounds)
• provide safety measures( adequate lighting, raised side rails) to prevent injuries
• Advice to avoid sudden upright position from bed to avoid postural hypotension.

5.

spironolactone is a potassium-sparing diuretic while it secretes sodium

.mainly used in patients with high risk of hypokalemia.

so,

• instruct to avoid potassium-rich diet
• regular monitoring of serum potassium level