Diuretic – Pharmacology for Nurses: Practical Applications

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Chapter 28: Diuretic Drugs Test, Hypertension, Pharmacology for Nurses: Practical Applications

The key terms in this Pharmacology course include Diuretic Drugs, Pharmacology for Nurses: Practical Applications


A 79-year-old patient is taking a diuretic for treatment of hypertension. This patient is very independent and wants to continue to live at home. The nurse will know that which teaching point is important for this patient?

He should skip the diuretic dose if he plans to leave the house.

He needs to take extra precautions when standing up because of possible orthostatic hypotension and resulting injury from falls.

He should take the diuretic with his evening meal.

If he feels dizzy while on this medication, he needs to stop taking it and take potassium supplements instead.

Caution must be exercised in the administration of diuretics to the older adults because they are more sensitive to the therapeutic effects of these drugs and are more sensitive to the adverse effects of diuretics, such as dehydration, electrolyte loss, dizziness, and syncope. Taking the diuretic with the evening meal may disrupt sleep because of nocturia. Doses should never be skipped or stopped without checking with the prescriber.


Furosemide (Lasix) is prescribed for a patient who is about to be discharged, and the nurse provides instructions to the patient about the medication. Which statement by the nurse is correct?

“If you experience weight gain, such as 5 pounds or more per week, be sure to tell your physician during your next routine visit.”

“Avoid foods high in potassium, such as bananas, oranges, fresh vegetables, and dates.”

“Take this medication in the evening.”

“Be sure to change positions slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes.”

Orthostatic hypotension is a possible problem with diuretic therapy. Foods high in potassium should be eaten more often, and the drug needs to be taken in the morning so that the diuretic effects do not interfere with sleep. A weight gain of 5 pounds or more per week must be reported immediately.


When monitoring a patient who is taking hydrochlorothiazide (HydroDIURIL), the nurse notes that which drug is most likely to cause a severe interaction with the diuretic?

Aspirin

Potassium supplements

Penicillin

Digitalis

There is an increased risk for digitalis toxicity in the presence of hypokalemia, which may develop with hydrochlorothiazide therapy. Potassium supplements are often prescribed with hydrochlorothiazide therapy to prevent hypokalemia. The other options do not have interactions with hydrochlorothiazide.


The order for a child reads, “Give furosemide (Lasix) 2 mg/kg IV STAT.” The child weighs 33 pounds. Identify how many milligrams the child will receive for this dose. __Please follow your answer with mg.

Correct Answer

30 mg

First, convert 33 pounds to kilograms: 33 pounds ÷ 2.2 = 15 kg.
Next, calculate mg/kg: 2 mg/kg × 15 kg = 30 mg.


A patient is started on a diuretic for antihypertensive therapy. The nurse expects that a drug in which class is likely to be used initially?

Loop diuretics

Thiazide diuretics

Potassium-sparing diuretics

Osmotic diuretics

The Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-8) guidelines reaffirmed the role of thiazide diuretics as among the first-line drugs in the treatment hypertension. The other drug classes are not considered first-line treatments.