Thiazide diuretics work to block the chloride pump, which leads to a loss of sodium, potassium, and some water. They are considered mild diuretics. Carbonic anhydrase inhibitors work to block the formation of carbonic acid and bicarbonate in the renal tub
Carbonic anhydrase inhibitors
Patients taking a diuretic at home need to learn to weigh themselves every day, at the same time, and in the same clothes to monitor for loss or retention of fluid. They should not be asked to measure urine output or to decrease activity. Restricting flui
Decrease exercise to conserve energy
To weigh themselves on the same scale, at the same time of day, in the same clothing
Restrict fluids to 500 mL/d to limit the need to urinate
Measuring intake and output of urine
Furosemide is associated with loss of potassium, so that the patient will need to be monitored carefully for low potassium levels, which could cause cardiac arrhythmias and further aggravate pulmonary edema. The nurse would not monitor sodium or calcium l
Bone narrow function
Because of its effects in the GI tract, cholestyramine should be taken at least 2 hours earlier or later than hydrochlorothiazide to ensure the absorption of hydrochlorothiazide. This combination of drugs can be used effectively. An antacid would further
Make sure that the drugs are given at least 2 hours apart.
Check the patient's blood glucose level before giving the drugs.
Call the physician and refuse to give the drugs without further orders.
Give the patient an antacid with the drugs.
Alkalosis is a drop in serum pH to an alkaline state due to bicarbonate loss in urine. Hypokalemia, hypocalcemia, and hypotension are also adverse effect of these drugs. Therefore, the other options are not correct.
Acetazolamide is used to treat glaucoma. The inhibition of carbonic anhydrase results in decreased secretion of aqueous humor of the eye. Spironolactone is a potassium-sparing diuretic used to treat edema caused by congestive heart failure, liver disease,
Hypokalemia results from the loss of potassium in the distal tubule and causes muscle weakness, fatigue, and arrhythmias. Hyperkalemia presents with cardiac arrhythmias and occasionally muscle weakness. Hypercalcemia is characterized by fatigue, depressio
Peaches, as well as bananas, oranges, raisins, and other fruits, spices, and vegetables are high in potassium and consuming them should be encouraged when taking furosemide. Apples, pears, and pineapple, however, do not replace potassium in the body.
The nurse will administer 210 mg/dose of the drug (2.2 pounds: 1 kg = 76 pounds: × kg, 76 divided by 2.2 = 34.5, 35 times 6 = 210 mg).
An increase in the excretion of lithium can occur when taken with acetazolamide, so that special monitoring or a dosage adjustment may be necessary. Indomethacin, colestipol, and ibuprofen do not produce drug-to-drug interactions when given with acetazola
Caution should be used with the following conditions, which include systemic lupus erythematosus (SLE), which frequently causes glomerular changes and renal dysfunction that could precipitate renal failure in some cases; glucose tolerance abnormalities or
He or she will need to have him or her urine checked for ketones four times a day.
His or he insulin dose may need to be decreased.
He or she will need to have a creatinine clearance done once a month.
His or her insulin dose may need to be increased.
Uric acid excretion is decreased because thiazides interfere with its secretory mechanism. High levels of uric acid can result in a condition called gout. Hydrochlorothiazide does not reduce BUN levels. Thiazide diuretics may lead to hypokalemia and incre
Elevated uric acid levels
A hemoglobin A1C of 4.8
A serum potassium level of 4.7 mEq/L
Reduced blood urea nitrogen (BUN) levels
Daily weights and blood pressures should be monitored at home in a patient taking diuretics. Options B, C, and D would indicate that further teaching is needed.
“I will take my medication before bedtime on an empty stomach.”
“If my leg gets swollen again, I'll take an additional pill.”
“I will have to limit my high sugar foods.”
“I will weigh myself daily and report significant changes.”
Potassium is the most important element to monitor in the diet because diuretics are most likely to lead to hyper- or hypokalemia depending on the diuretic prescribed. Calcium, glucose, and magnesium may need to be monitored in the diet but potassium woul
The risk of ototoxicity increases if loop diuretics are combined with aminoglycoside antibiotics (gentamicin) or cisplatin. No known increased risk of ototoxicity exists when furosemide is taken with codeine, ciprofloxacin, or digoxin.
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