Hydrochlorothiazide – Pharmacology for Nurses: Practical

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

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


For a patient prescribed hydrochlorothiazide, the nurse should closely monitor which laboratory test value?

Sodium

Glucose

Calcium

Chloride

Thiazide and thiazide-like diuretics are associated with adverse metabolic effects of hyperglycemia; therefore, close monitoring of blood glucose levels are needed. Other metabolic disturbances include hyperlipidemia and hyperuricemia.


The nurse is providing education to a patient prescribed spironolactone and furosemide. What information does the nurse explain to the patient regarding both medications together?

This combination promotes diuresis but decreases the risk of low levels of potassium.

This combination maintains water balance to protect against dehydration and electrolyte imbalance.

The lowest dose of two different types of diuretics is more effective than a large dose of one type.

Using two drugs increases blood osmolality and the glomerular filtration rate.

Spironolactone is a potassium-sparing diuretic; furosemide is a potassium-losing diuretic. Giving these together minimizes potassium loss.


A patient in the neurologic intensive care unit is being treated for cerebral edema. Which class of diuretic is used to reduce intracranial pressure?

Thiazide diuretics

Loop diuretics

Vasodilators

Osmotic diuretics

Mannitol, an osmotic diuretic, is commonly used to reduce intracranial pressure and cerebral edema resulting from head trauma.


The nurse will monitor a patient for signs and symptoms of hyperkalemia if the patient is taking which of these diuretics?

Hydrochlorothiazide (HydroDIURIL)

Furosemide (Lasix)

Acetazolamide (Diamox)

Spironolactone (Aldactone)

Spironolactone (Aldactone) is a potassium-sparing diuretic, and patients taking this drug must be monitored for signs of hyperkalemia. The other drugs do not cause hyperkalemia but instead cause hypokalemia.


A patient is being discharged to home on a single daily dose of a diuretic. The nurse instructs the patient to take the dose at which time so it will be least disruptive to the patient’s daily routine?

At bedtime

At noon

With supper

In the morning

It is better to take the diuretic medication early in the morning to prevent urination during the night. Taking the diuretic at the other times may cause nighttime urination and disrupt sleep.


When reviewing the mechanisms of action of diuretics, the nurse knows that which statement is true about loop diuretics?

They work by inhibiting aldosterone.

They have a rapid onset of action and cause rapid diuresis.

They are not effective when the creatinine clearance decreases below 25 mL/min.

They are very potent, having a diuretic effect that lasts at least 6 hours.

The loop diuretics have a rapid onset of action; therefore, they are useful when rapid onset is desired. Their effect lasts for about 2 hours, and a distinct advantage they have over thiazide diuretics is that their diuretic action continues even when creatinine clearance decreases below 25 mL/min.