Question

Diuretics 1. What is the prototype for Loop of Henle diuretics? 2. What are the indications, effects, major side effects and nursing implications of (furosemide) Lasix? 3. When should Diuretics be given? 4. What is the common electrolyte imbalance with diuretics? 5. Discuss HCTZ effects, side effects and implications?

Answer 1

Ans:-

1. Furosemide is the prototype of loop of Henle diuretic.

2.a. Indications of furosemide are:-

I) cerebral edema, pulmonary edema, renal edema, hepatic edema.

II) after blood transfusion

III) In case of hypertension

IV) Heart failure

b.Effects

I)increased excretion of sodium,potassium,magnesium,calcium by inhabiting the luminal Na-K-Cl cotransporter.

Side Effects of furosemide are:-

I) reduces blood pressure (hypotension)

II) Azotemia

III) hyponatremia, hypokalemia,

IV) hypomagnisemia,hypocalcemia

V) Hyperglycemia and Hyperlipidemia

Nursing implications are:-

I)Monitor electrolytes level

II) Monitor renal and hepatic function,

III) observe sign of hyperglycemia and estimate serum glucose, and uric acid levels before and periodically throughout therapy.

IV) Regularly monitor for increased BUN, serum glucose, creatinine, and uric acid levels.

V) Asses fluid status and check for signs of dehydration like dry mucous membrane, skin turgor etc.

VI)Monitor daily weight

VII)Document intake and output ratios

VIII)Note amount and location of edema

IX)Auscultate lung sounds

X)Monitor BP to check hypotension

3. Diuretics should be given in morning time on empty stomach either 1hr before food or 2-3 hr after food.

If the dose is twice a day than first dose should be given in morning and the second dose should be given in late afternoon.

It should be given at same time each day.

4. Common electrolyte imbalance is:-

Furosemide induces variouselectrolyte imbalances including hypokalemia, hypomagnesemia, hypocalcemia, hyponatremia, and hyperuricemia

5.Hydrochlorothiazide (HCTZ)

Effects include:-

I)Increase excretion of sodium, chloride, potassium and magnesium ions.

II)Reduce calcium excretion and promote calcium reabsorption.

Side effects include:-

I) constipation, diarrhea, dizziness, nausea, loss of appetite, and headache.

I) electrolyte imbalance -potassium depletion,sodium depletion, hypercalcemia

IV) orthostatic hypo tension

V) metabolic disorders- Hyperglycemia, hyperuricemia

Implications include :-

Monitor intake and output

monitor for oligouria,drowsiness; dry mouth; excessive thirst; increased heart rate or pulse;

Ask the patient for muscle cramps;nausea or vomiting; or unusualtiredness or weakness.