Question

PN 105 Fundamentals of Nursing I Case Study: Hypertension/Hydrochlorothiazide Joe Quan is a 58-year-old patient, recently diagnosed with hypertension. His resting blood pressure is 58/92. He is prescribed hydrochlorothiazide 50mg/day and told to eat food rich in potassium. 1. How does hydrochlorothiazide differ from furosemide (Lasix)? What are there similarities and their differences? 2. Why is it necessary for Joe to eat food rich in potassium when taking hydrochlorothiazide? Explain your answer 3. What are the nursing interventions that should be considered while Joe takes hydrochlorothiazide? After one month on hydrochlorothiazide therapy, Joe becomes weak and complains of nausea and vomiting. His muscles are "soft". His serum potassium level is 3.3 mEq/L. Joe's diuretic is changes to triamterene /hydrochlorothiazide (Diazide). Again he is advised to eat foods rich in potassium. Explain the rationale for changing Joe's diuretic. 4. Should Joe receive a potassium supplement? Explain your answer 5. What nursing interventions should the nurse follow for Joe? 6.

Answer 1

Ans) 1 Similarities between Lasix & Hydrochlorothiazide:

- Both are diuretics which help to increase excretion of water from body.

Difference between Lasix & Hydrochlorothiazide:

- Lasix (Furosemide) is a very effective water pill and it'll certainly make you go to the bathroom more often. Removes water from the body, which lowers blood pressure. Microzide (hydrochlorothiazide (HCTZ)) is a well-tolerated water pill that's often the first-choice treatment for mild high blood pressure.

2) Hydrochlorothiazide (HydroDIURIL) overdose leads to hypokalemic symptoms, which are characterized by muscle weakness and hypotension. The nurse should immediately assess the patient's serum potassium level to determine the course of action. Giving calcium supplements alone does not reduce the symptoms caused by potassium deficiency. Decreasing the salt intake would further reduce the patient's blood pressure and cause sodium deficiency. Reducing the dose of the medication will not help restore the electrolyte balance.

3) Hydrochlorothiazide (HydroDIURIL) is a thiazide diuretic that is used in the treatment of various types of edema. Diuretics are to be taken in the morning because they cause urination at night (nocturia) and subsequent loss of sleep when taken late in the afternoon or night. Therefore, the nurse should instruct the patient to take the medication only in the morning to avoid the side effects of the drug. The nurse can suggest that the patient eat fiber-rich food such as oats, because this helps prevent constipation, but not because of being a diuretic. Due to loss of fluids, the patient may have dehydration. Hence the nurse can suggest that the patient eat fruits high in fluid content such as melons and grapes. This medication does not cause anemia; therefore, patient need not take iron supplements.

4) Acetazolamide is used to prevent and reduce the symptoms of altitude sickness. This medication can decrease headache, tiredness, nausea, dizziness, and shortness of breath.