Chapter 28: Diuretic Drugs Test, Mannitol, Pharmacology for Nurses: Practical Applications
The key terms in this Pharmacology course include Diuretic Drugs, Mannitol, Therapeutic effects, Pharmacology for Nurses: Practical Applications
To evaluate the therapeutic effects of mannitol, the nurse should monitor the patient for which clinical finding?
Decrease in intracranial pressure
Increase in urine osmolality
Decrease in serum osmolality
Increase in cerebral blood volume
Mannitol is an osmotic diuretic that pulls fluid from extravascular spaces into the bloodstream to be excreted in urine. This decreases intracranial pressure and cerebral blood volume, increases excretion of medications, decreases urine osmolality, and increases serum osmolality.
When preparing to administer intravenous furosemide to a patient with renal dysfunction, the nurse will administer the medication no faster than which rate?
Furosemide controlled infusion rate should not exceed at a rate of 4 mg/min in patients with renal failure.
The nurse would question the use of mannitol for which patient condition?
Anuria related to end-stage kidney disease
Increased intraocular pressure
Cerebral edema from head trauma
Oliguria from acute renal failure
Mannitol does not influence urine production; it only increases existing urine output. It is not metabolized but excreted unchanged in the urine by the kidneys. Thus, if no urine is produced (anuria), mannitol is not excreted, which increases blood volume. Excess blood volume may cause the undesirable adverse effect of pulmonary edema.
Why does the health care provider prescribe furosemide 40 mg twice a day by mouth for a patient with a history of renal insufficiency?
Furosemide is effective in treating patients with hypoaldosteronism.
Furosemide has an antagonist effect to prevent respiratory alkalosis.
Furosemide helps the kidney with reabsorption of sodium and water.
Furosemide is effective in treating patients with impaired kidney function.
Furosemide effectiveness continues in impaired renal function. When creatinine clearance decreases below 25 L/min (normal is 125 L/min), the loop diuretics can still work.
A patient asks the nurse about using potassium supplements while taking spironolactone. What is the nurse’s best response?
“I would recommend that you take two multivitamins every day.”
“I will call your health care provider and discuss your concern.”
“You will need to take potassium supplements for the medication to be effective.”
“This diuretic is potassium sparing, so there is no need for extra potassium.”
Spironolactone is a potassium-sparing diuretic, and thus the patient does not need potassium supplementation. Intake of excess potassium may lead to hyperkalemia.
To treat a patient with pulmonary edema, the nurse prepares to administer which diuretic to this patient?
Furosemide is a potent, rapid-acting diuretic that would be the drug of choice to treat pulmonary edema. The other medications are not potent enough to cause the diuresis necessary to treat this condition.