LPN 142 Cardiac Unit Ch 33-39 (1)Student (1).pptx - Cardiovascular Unit VIII Chapter 33-36 38-39 Diuretics Chapter 33 2 Kidney Anatomy \u2022 Nephron The

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Cardiovascular Unit VIII Chapter 33-36, 38-39
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Diuretics Chapter 33 2
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Kidney Anatomy Nephron: The functional unit of the kidney Proximal convoluted tubule Loop of Henle Descending limb Ascending limb Distal convoluted tubule Collecting duct 3
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Diuretics Works by altering the excretion or reabsorption of electrolytes Or drugs that act by disrupting solute reabsorption in the nephron of the kidney. Edema: Accumulation of excess water in the body associated with heart failure 4
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Classification of Diuretics Loop diuretics Furosemide (LASIX), IV (about 5 min) or orally (60 min) Thiazide diuretics hydrochlorothiazide Osmotic diuretics Mannitol Potassium sparing diuretics Aldactone Carbonic anhydrase inhibitors Used for intraocular pressure (IOP) Watch for hyperkalemia and hypernatremia 5
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Loop Diuretics Action Increase excretion of Na+, Cl-, and K+; Inhibit reabsorption of these in the distal and proximal tubules in the loop of Henle Furosemide (Lasix) – Acts primarily in the ascending portion of the loop of Henle Torsemide (Demadex), Bumetanide (Bumex), ethacrynic (Edecrin) Watch hypokalemia and hyponatremia Severe renal problems patients pulls fluid off for them 6
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Loop Diuretics USES Pulmonary edema (CHF) Edema Hypertension 7
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Adverse Reactions Electrolyte imbalance Hyponatremia hypokalemia Dehydration Hypotension Ototoxicity Hyperglycemia 8
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Contraindication/Drug interactions Digoxin Risk of digoxin toxicity r/t hypokalemia Lithium Increased risk of lithium toxicity NSAIDS Decreased diuretic effectiveness Anticoagulants: Increased risk for bleeding. Contraindicated: Anuria Severe Liver or Renal dysfunction
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Thiazides Hydrochlorothiazide (HCTZ), Metolazone (Zaroxolyn), Chlorthalidone, Indapamide ACTION: Inhibit reabsorption of sodium and chloride ions USES Essential hypertension Edema 10
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Adverse Effects/ Contraindications Allopurinol (GOUT) Increased risk of hypersensitivity Antidiabetic Hyperglycemia Use cautiously in pregnancy Has effects on amniotic fluid May have cross sensitivity reaction may occur with the thiazides and sulfonamides 11
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Potassium sparing diuretics Spironolactone (Aldactone), Amiloride, Triamterene Block aldosterone (hormone that promotes retention of Na+ and H20 and secretion of K+), which in turn allows H20 and Na+ to be excreted and K+ retained. Adverse Effects: hyperkalemia, gynecomastia Contraindications: foods high in K+, ACE inhibitors (Lisinopril) 12
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Osmotic Diuretics Mannitol, urea, glycerin Inhibits passive reabsorption of water Uses Increased intracranial pressure Reduction of intraocular pressure Adverse Effects/Contraindications Edema Headache/blurred vision N/V Patients with active intracranial bleeding.
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