Question

Case Study, Chapter 51, Diuretic Agents

A nursing student is preparing medication cards on diuretics for a clinical experience on a medical floor. The student has been assigned to two patients: a young adult and an older adult. The student has to do teaching with a client on furosemide (Lasix). The faculty member has requested that the student nurse do a 5-minute preconference presentation on the various types of diuretics. (Learning Objectives 2, 3, and 5)

1. What are the key therapeutic actions, indications, and most common adverse effects of diuretics?
2. What are the key therapeutic actions and indications for the five types of diuretics?
3. What are the most important teaching points for a patient receiving furosemide (Lasix)?
4. What is the use of diuretic agents across the lifespan?

Answer 1

1. Diuretics are the drugs which promotes diuresis means increased production of urine . There are different types of diuretics and their mechanism of action are :-

- osmotic diuretic = inhibits sodium and water reabsorption

- loop diuretic = inhibits sodium , chloride ,and potassium cotransport.

- potassium sparing diuretic = inhibitors sodium reabsorption and potassium secretion

- thiazide = inhibits sodium, chloride , and potassium cotransport

Indications of diuretics are :-

- congestive heart failure

- acute pulmonary edema

- renal disease

- liver disease

- hypertension

- condition causing hyperkalemia

- cerebral edema

Side effects of diuretics are :-

- excessive volume depletion

- circulatory collapse

- azotemia

- hypokalemia

- hypocalcemia

- hypomagnesemia

- ototoxicity

- cardiac arrhythmia

2. The different types of diuretics and it's mechanism of action are :-

- osmotic diuretic = inhibits water and sodium reabsorption

- loop diuretic and thiazide diuretics = inhibits sodium, potassium, and chloride cotransport

- potassium sparing diuretic = inhibits sodium reabsorption and potassium secretion

- carbonic anhydrase inhibitor = inhibits bicarbonate reabsorption

Indications of diuretics are :-

- renal disease

- liver disease

- congestive heart failure

- cerebral edema

- hypertension

- pulmonary edema

- conditions like hyperkalemia , hypercalcemia

3. The important teaching points for a patient receiving furosemide are :-

- complainance to medications

- health education regarding regular diet ( high in potassium ) and exercise

- don't miss the dose and if missed then take the medicine as soon as remembered.

- don't double the dose when you miss the dose in between

- warn patient about increased urination for 6 hours after taking the medication

- caution patient to change position slowly to minimize orthostatic hypotension

- contact the physician if weight gain of 3lbs in a day

- caution patient to contact physician if rashes ,dizziness , numbness ,tingling etc occurs .

- advise diabetic patient to monitor blood glucose as furosemide causes increased blood glucose .

- caution patient to use protective clothing and sunscreen to avoid photosensitivity reaction

- caution geriatric patients and care givers about fall

4. There is no direct use of diuretics for lifespan ,but it's used for hypertension, heart disease, renal disease etc to prolong the longevity of patient indirectly by reducing the complications associated with the indicated diseases.