Pharmacology and the Nursing Process7: ch 28 Flashcards
Before deciding whether the patient receives a diuretic, what are you looking for in your assessment of the patient?
- assess potassium level
- asses for drug interactions (look at each type of diuretic and know the selected drugs that interact)
- assess past medical history (look for contraindications as specified for each drug)
- assess weight for baseline
- assess vital signs-look especially at blood pressure since diuretics decrease circulating volume, which can lower blood pressure
What would the nurse's plan include when using a diuretic?
- patient will have balance intake and output ratios
What nursing interventions would the nurse use to minimize adverse effects when administering a diuretic?
- monitor blood pressure throughout therapy
- monitor for fluid retentions-edema, weight gain (weigh patient daily)
- monitor intake of and output, looking at balance
- monitor potassium levels and for signs of electrolyte imbalances
- if giving furosemide intravenously, give at a rate no faster than 20 mg/min. If given too rapidly, furosemide can cause transient hearing loss
- monitor for gout-like symptoms with loop and thiazide diuretics
- check blood sugar more frequently in diabetic patient's prescribed loop or thiazide diuretics
What would the nurse ensure the patient understands when administering a diuretic?
- teach to rise slowly in stages related to orthostatic hypotension(especially the elderly)
- teach t either increase potassium intake (potassium wasting diuretics) or decrease potassium intake (potassium-sparing diuretics)
- teach to weigh daily (in the same clothes at the same time, on the same scale) and record their weight and report weight gain of greater than 5 pounds in 2 days
- teach diabetic patients that thiazide diuretics and loop diuretics cause hyperglycemia and may decrease the effectiveness of their antidiabetic medication
Which are indications for the use of diuretics?
When providing patient teaching to, the nurse will include which dietary guidelines?
When teaching a patient about diuretic therapy, which would the nurse indicate as the best time of day to take these medications?
When monitoring a patent for hypokalemia related to diuretic use, the nurse looks for which possible symptoms?
A patient with severe heart failure has been started on therapy with a carbonic anhydrase inhibitor (CAI), but the nurse mentions that this medication may be stopped in a few days. What is the reason for this short treatment?
A patient has a new order for daily doses of spironolactone (Aldactone). Which condition, if present, may be a contraindication to this drug therapy?
The nurse is reviewing the medications that have been ordered for a patient for whom a loop diuretic may have a possible interaction with which of the following?
When monitoring laboratory test results for patients receiving loop and thiazide diuretics, the nurse knows to look for
When the nurse is checking the laboratory data for a patient taking spironolactone (Aldactone), which result would be a potential concern?
Which statement needs to be included when the nurse provides patient education for a patient with heart failure who is taking daily doses of spironolactone (Aldactone)
A patient with diabetes has a new prescription for a thiazide diuretic. Which statement will the nurse include when teaching the patient about the thiazide drug?
An elderly patient has been discharged following treatment for a mild case of heart failure. He will be taking a loop diuretic. Which instruction(s) from the nurse are appropriate?