Diuretics

A nurse is providing patient teaching for a 62-year-old woman who is taking triamterene. The nurse will teach the patient to avoid what in her diet? Avocados Bell peppers Mushrooms Fresh pineapple

Avocados

The client is at an increased risk for hearing loss if taking furosemide with what medication? Codeine Ciprofloxacin Digoxin Gentamicin

Gentamicin

The nurse assesses a client receiving furosemide for: Acidosis Hypercalcemia Hypotension Hypoglycemia

Hypotension

Hydrochlorothiazide works by what mechanism of action? Decreasing sodium absorption in the loop of Henle Promoting increased chloride concentrations in the urine Increasing the excretion of sodium and chloride in the distal tubule Increasing water reabsorption in the ascending loop of Henle

Increasing the excretion of sodium and chloride in the distal tubule

A nurse is preparing to administer a diuretic that antagonizes the action of aldosterone. Which drug would the nurse be most likely to administer? Spironolactone Furosemide Hydrochlorothiazide Acetazolamide

Spironolactone

When providing medication teaching to a client who has been prescribed spironolactone, what foods should the nurse instruct the client to avoid? fish apples crackers bananas

bananas

A nurse understands that loop diuretics are considered high ceiling diuretics because they: cause a greater diuresis. are associated with more adverse effects. cause a greater loss of potassium. require large doses to achieve effect.

cause a greater diuresis.

After teaching a group of nursing students about diuretics, the instructor determines that the teaching was successful when the group identifies which as a loop diuretic? Furosemide Hydrochlorothiazide Acetazolamide Spironolactone

furosemide

Which instruction would be most appropriate for a client who is taking a diuretic? "Take the daily dose around dinnertime." "It's okay to take it with food." "Lie down after taking the drug." "Limit the amount of fluids you drink."

"It's okay to take it with food."

A client asks, "Why is my prescription being switched from furosemide to spironolactone?" What is the nurse's best response? "You will lose less potassium with spironolactone than with furosemide." "You will have greater potassium losses with spironolactone than with furosemide." "You will have greater water losses with spironolactone than with furosemide." "You will have greater sodium losses with spironolactone than with furosemide."

"You will lose less potassium with spironolactone than with furosemide."

A nurse demonstrates understanding of diuretics when identifying which medication as exerting its effect by inhibiting the enzyme carbonic anhydrase? Acetazolamide Furosemide Hydrochlorothiazide Spironolactone

Acetazolamide

When describing the action of spironolactone, the nurse would explain that this drug acts by: Blocking potassium secretion through the tubule Slowing the movement of hydrogen ions Blocking the chloride pump Blocking aldosterone in the distal tubule

Blocking aldosterone in the distal tubule

A 91-year-old client is being discharged on the diuretic spironolactone. What assessment finding would the nurse attribute to adverse effects of this medication? Polyuria and polyphagia Confusion and irregular heart rate Diarrhea and positive stool for occult blood (FOB) test Blood pressure of 160/109 mm Hg

Diarrhea and positive stool for occult blood (FOB) test

The pharmacology instructor is discussing the various diuretic agents and their sites of action in the nephron. In what part of the nephron do thiazide diuretics act? Proximal tubule Descending limb of the loop of Henle Ascending limb of the loop of Henle Distal tubule

Distal tubule

An elderly patient with a history of congestive heart failure has been admitted to hospital with failure to thrive and admission blood work reveals a hemoglobin level of 6.9 g/dL. The care team has consequently administered two units of packed red blood cells, but auscultation of the client's lungs now reveals diffuse crackles. Administration of what drug is likely to resolve the patient's pulmonary edema? Furosemide Hydrochlorothiazide Mannitol Triamterene

Furosemide

A client prescribed both an ACE inhibitor and a beta-blocker for the treatment of hypertension has been consistently obtaining blood pressure readings in the vicinity of 145/90 mm Hg. As a result, the client's primary health care provider has prescribed furosemide. What order would be most consistent with this client's health needs? Furosemide 125 mg PO OD Furosemide 40 mg IV TID Furosemide 20 mg IV OD Furosemide 40 mg PO BID

Furosemide 40 mg PO BID

A 64-year-old client in hypertensive crisis is to receive furosemide 40 mg IV. Furosemide comes in 100 mg/10 mL containers. What is the correct action by the nurse when giving the prescribed medication? Give 4 mL over 1 to 2 minutes. Give 4 mL over 10 minutes. Flush the line with normal saline, give 4 mL at 1 mL/min, flush again when finished. Fix 10 mL in an IV piggyback and deliver it over 30 minutes.

Give 4 mL over 1 to 2 minutes.

A health care provider prescribes spironolactone, a potassium-sparing diuretic, for a client with cirrhosis. For which category of clients is the use of potassium-sparing diuretics contraindicated? hyperkalemia liver disease gout diabetes

Hyperkalemia

An older adult client has a complex medical history that includes heart failure, type 1 diabetes, and diabetic nephropathy. The nurse has questioned a health care provider's prescription for oral spironolactone because the client's health problems would contribute to a high risk of which adverse reaction? Metabolic acidosis Hypocalcemia Hemolytic anemia Hyperkalemia

Hyperkalemia

A client who has been taking hydrochlorothiazide arrives at the clinic for his 1-month follow-up appointment. The client tells the nurse that he feels weaker since he began taking the drug. What should the nurse consider as a possible cause of these symptoms? Hypercalcemia Hypocalcemia Hyperkalemia Hypokalemia

Hypokalemia

A nurse notes that a newly admitted client is currently prescribed both a loop diuretic as well as a thiazide diuretic. The nurse understands what primary rationale for the concurrent use of these two drugs? Increased diuretic effect Reduced risk of potassium imbalances Decreased blood pressure without a risk of bradycardia Increased adherence to treatment

Increased diuretic effect

A client is admitted to the emergency department with pulmonary edema. What diuretic does the nurse expect the health care provider to prescribe to achieve rapid therapeutic effect? Loop diuretic Thiazide Potassium-sparing diuretic Osmotic diuretic

Loop diuretic

When describing where bumetanide acts, what would the nurse include? Proximal convoluted tubule Loop of Henle Collecting tubule Glomerulus

Loop of Henle

The emergency department (ED) nurse is caring for a client who is experiencing pulmonary edema. The client is treated with furosemide. What will the nurse monitor most closely? Sodium levels Bone narrow function Calcium levels Potassium levels

Potassium levels

The pharmacology instructor is discussing the differences among the various diuretic agents. Which would the instructor cite as a difference between spironolactone and hydrochlorothiazide? Potassium losses are greater with spironolactone than with hydrochlorothiazide. Potassium losses are greater with hydrochlorothiazide than with spironolactone. Spironolactone is more likely to be taken with a potassium supplement. The two diuretics act in different parts of the nephron.

Potassium losses are greater with hydrochlorothiazide than with spironolactone.

A nurse obtains an allergy history from a client based on the understanding that which class is associated with a cross-sensitivity reaction with sulfonamides? Thiazide diuretics Carbonic anhydrase inhibitors Potassium-sparing diuretics Osmotic diuretics

Thiazide diuretics

The nurse is providing discharge instructions to a 72-year-old client who has been discharged home on a diuretic. What should the nurse include when providing discharge instructions regarding the use of a diuretic at home? Measuring intake and output of urine To weigh themselves on the same scale, at the same time of day, in the same clothing Restrict fluids to 500 mL/day to limit the need to urinate Decrease exercise to conserve energy

To weigh themselves on the same scale, at the same time of day, in the same clothing

A client is receiving triamterene. The nurse instructs the client to avoid what foods? (Select all that apply.) Bananas Prunes Lettuce Broccoli Apples

bananas prunes broccoli

The nurse is caring for an older adult client who receives furosemide on a regular basis. The nurse should prioritize assessments related to what health problem? dehydration urinary retention hypernatremia dysrhythmias

dehydration

A 49-year-old client reports frequent muscle cramps while on hydrochlorothiazide therapy. The nurse would advise the client to do which? drink plenty of fluids. eat potassium-rich foods. take calcium supplements. include high-sodium foods in her diet.

eat potassium-rich foods.

Which diuretic will most likely be the initial drug of choice when a client demonstrates dyspnea related to pulmonary edema? furosemide hydrochlorothiazide spironolactone mannitol

furosemide

Which is an example of a loop diuretic? Furosemide (Lasix) Hydrochlorothiazide (Microzide) Acetazolamide (Diamox) Spironolactone (Aldactone)

furosemide

A client with renal impairment is in need of a diuretic. Because of the renal problem, potassium-sparing diuretics are contraindicated but may be used if there is no other option. If they are used at all, what nursing intervention would be most important for this client? Administration of concurrent potassium Monitoring of serum electrolytes, creatinine, and BUN Administration of a thiazide diuretic Monitoring of CBC and serum albumin

monitor electrolytes, creatinine, BUN

An adult client with multiple chronic health problems has been prescribed furosemide in the management of hypertension. When reviewing this client's current medication administration record, what drug should signal the nurse to a potentially increased risk of hypokalemia? prednisone vitamin D ibuprofen calcium carbonate

prednisone

What would be a contraindication to the use of carbonic anhydrase inhibitors? Allergy to sulfonamides Adrenocortical insufficiency Respiratory acidosis Chronic obstructive pulmonary disease

Allergy to sulfonamides

A client who is allergic to sulfonamide would use what diuretic cautiously? Hydrochlorothiazide Furosemide Bumetanide Torsemide

Hydrochlorothiazide

A 91-year-old client, who is being prepared for discharge, has been prescribed the diuretic spironolactone. While teaching the client about the drug, what major adverse effect should the nurse be sure to mention? Hypokalemia Hyperkalemia Angina Hypertension

Hyperkalemia

A client presents to the clinic for a 1-month follow-up appointment. The client tells the nurse he or she has been taking chlorothiazide for a month and now has leg cramps and "feels tired all the time." What will the nurse consider as the most likely cause of the client's symptoms? Hypercalcemia Hypocalcemia Hyperkalemia Hypokalemia

Hypokalemia

Following a referral from the client's optometrist, a client has been assessed and diagnosed with open-angle glaucoma. When administering the client's subsequent medications, the nurse should prioritize what action? Limit the client's fluid intake to 2 L/day, as prescribed. Monitor the client's potassium levels. Submit urine for culture and sensitivity 48 hours after starting treatment. Educate the client about the need to wear eye patches temporarily.

Monitor the client's potassium levels.

What would contraindicate the use of indapamide? Diabetes Systemic lupus erythematosus Renal disease Gout

Renal disease

A male client has cirrhosis and is receiving diuretic therapy. The nurse knows that what drug will help prevent metabolic alkalosis or hypokalemia in this client? Spironolactone Dyazide Hydrochlorothiazide Bumetanide

Spironolactone

An adult client with a diagnosis of hypertension has been prescribed oral furosemide. What goal should the nurse identify when planning this client's medication teaching session? The client will identify strategies for limiting sodium intake. The client will describe the rationale for increasing fluid intake. The client will be able to demonstrate correct technique for blood glucose monitoring. The client will accurately describe the basic structure and functions of the kidneys.

The client will identify strategies for limiting sodium intake.

The health care provider indicates that a client experiencing renal failure is not a candidate for therapy with potassium-sparing diuretics. How will the nurse respond when the client's family member asks why this is the case? They may cause hyperkalemia. They are the strongest form of diuretics. They promote excretion of potassium. They may cause rebound edema.

They may cause hyperkalemia.

A female client is diagnosed with hyponatremia. What type of diuretic would most likely cause this symptom? Osmotic Thiazide Potassium sparing Loop

loop

The nurse is caring for a client with a severe head injury. An osmotic diuretic is ordered. The nurse understands which drug is an osmotic diuretic? Spironolactone Bumetanide Mannitol Ethacrynic

mannitol

A hospital client demonstrating peripheral edema has been prescribed furosemide. How should the nurse best determine the extent of the client's desired fluid loss? Assess the client's skin turgor on a daily basis. Test the osmolarity of the client's urine regularly. Weigh the client daily. Auscultate the client's chest each morning.

weigh the client daily

A patient with a longstanding diagnosis of chronic renal failure has experienced a significant decline in urine output in recent days, prompting him to seek care at a local clinic. A nurse at the clinic has suggested to a colleague that the administration of a diuretic such as hydrochlorothiazide may improve the patient's urine output. How should the colleague best respond to this suggestion? "That would probably help, but we'd have to do blood work first." "Actually, patients with renal failure usually can't take hydrochlorothiazide." "That would only work if he could come in twice a day to get it intravenously." "Maybe, but hydrochlorothiazide affects the bladder more than the kidneys."

"Actually, patients with renal failure usually can't take hydrochlorothiazide."

The nurse is teaching a 62-year-old client about hydrochlorothiazide, which the health care provider has prescribed for treatment of hypertension. What statement, made by the client, suggests that the client understands the teaching? "I will need to stand slowly." "I will need to make sure that I am consuming enough sodium." "I must take my medication on an empty stomach." "I can jump right into action!"

"I will need to stand slowly."

Diuretics increase the production and output of urine. Which statement helps explain how diuretics achieve these effects? Diuretics reduce the reabsorption of water in the kidneys. Diuretics increase production of nephrons. Diuretics increase the reabsorption of electrolytes in the kidneys. Diuretics have no effect on reabsorption.

Diuretics reduce the reabsorption of water in the kidneys.

What type of diet should a patient taking diuretics have? Eat sodium-rich or low-sodium diet as appropriate Eat potassium-rich or low-potassium diet as appropriate No effect on diet Eat low-sodium, low-potassium diet

Eat potassium-rich or low-potassium diet as appropriate

The nurse is preparing to administer the first dose of hydrochlorothiazide to a client. What assessment should the nurse perform prior to administration? Pulse rate Hemoglobin level Sulfonamide allergy Neutrophil level

Sulfonamide allergy

A client began taking hydrochlorothiazide 1 week ago and is reporting occasional dizziness when she stands up quickly from sitting or lying. What is the nurse's best action? Arrange for the client's potassium levels to be assessed as soon as possible. Teach the client about the blood pressure effects of the medication and relevant safety measures. Educate the client about the need for bed rest until her body adjusts to the new medication. Tell the client to withhold the next scheduled dose until she can be assessed by the provider.

Teach the client about the blood pressure effects of the medication and relevant safety measures.

Diuretics can either block the reabsorption of components of the urine or block the reabsorption of water back into the body. What does the increase in urine flow from the body depend on with a patient on loop diuretics? The amount of water reabsorption back into the body The amount of sodium and chloride reabsorption that it blocks The amount of sodium and chloride that it excretes through the kidney The amount of water excreted by the body

The amount of sodium and chloride reabsorption that it blocks

The nurse is conducting an admission assessment of a client who has been prescribed hydrochlorothiazide. The nurse should contact the provider because of the client's: allergy to sulfa drugs. allergy to codeine. recent BP of 160/96 mm Hg. recent blood glucose level of 140 mg/dL.

allergy to sulfa drugs.

A health care provider has prescribed triamterene to a male client with renal disease. The client informs the nurse that he is taking potassium supplements to address some heart problems. The nurse would be alert for: increased risk of hyperkalemia. increased risk of bleeding. decreased diuretic effectiveness. increased risk of arrhythmias.

increased risk of hyperkalemia.

An ED nurse is caring for a patient who is receiving furosemide for treatment of pulmonary edema. What will the nurse monitor to observe for adverse effects of the drug? Temperature Bone marrow function Blood oxygen saturation Potassium levels

k levels

A patient is prescribed a thiazide diuretic that is to be administered intravenously. Which agent would this most likely be? Chlorothiazide Hydrochlorothiazide Bendroflumethiazide Methyclothiazide

Chlorothiazide

A client receives a dose of furosemide intravenously at 8:00 AM. The nurse would expect this drug to exert is peak effects at which time? 8:15 AM 8:30 AM 8:45 AM 9:00 AM

8:30 AM

When describing the action of chlorothiazide, what would a nurse include? Blocking of the chloride pump Blocking the action of carbonic anhydrase Acting as an aldosterone antagonist Blocking of potassium secretion through the tubule

Blocking of the chloride pump

A male client is prescribed potassium-sparing diuretics to treat his disease process. During his annual visit to the health care provider, he reports experiencing muscle weakness and tingling in his fingers. What does the nurse suspect is wrong with this client? Hypokalemia Hyperkalemia Hypocalcemia Hypercalcemia

Hyperkalemia

After teaching a group of students about loop diuretics, the instructor determines that the teaching has been successful when the students identify which agent as the safest for use in the home? Furosemide Ethacrynic acid Bumetanide Torsemide

furosemide

A client has been prescribed both digoxin and furosemide. The nurse should monitor the client for development of what adverse effect? Hyperkalemia Hyperglycemia Tachycardia Digoxin toxicity

Digoxin toxicity

The nurse is writing a plan of care for a client who is taking a diuretic. What nursing diagnosis is most likely applicable? Impaired urinary elimination Ineffective peripheral tissue perfusion Imbalanced nutrition: less than body requirements Fluid volume excess

Impaired urinary elimination

The nurse has administered a diuretic that acts to block the chloride pump in the distal convoluted tubules and leads to a loss of sodium and potassium and a minor loss of water. What type of diuretic did the nurse administer? Carbonic anhydrase inhibitor Osmotic diuretic Potassium-sparing diuretic Thiazide diuretic

Thiazide diuretic

What substance is reabsorbed in the ascending limb of the loop of Henle? sodium water glucose amino acids

sodium