Diuretics Chapter 32

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 hydrochlorothiazide than with spironolactone.

A client with hypertension has been prescribed spironolactone. The client's previous diuretic, furosemide, has been discontinued. The nurse should explain what benefit of this change?

Potassium losses are lower with spironolactone than with furosemide.

A client is receiving digoxin and a potassium supplement. When monitoring daily laboratory values, what should the potassium level be for this client? You Selected:

3.5-5.0 mEq/L

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?

Hyperkalemia

The nurse is caring for a client with peripheral edema and has just begun taking a diuretic. What assessment should the nurse use to evaluate the effectiveness of this medication? Select all that apply.

daily weights inspection of the lower extremities urine output

A 49-year-old client reports frequent muscle cramps while on hydrochlorothiazide therapy. The nurse would advise the client to do which?

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

A physician has prescribed triamterene to a client with renal disease. The client informs the nurse that they are taking potassium supplements to address some heart problems. The nurse would be alert for which of the following?

increased risk of hyperkalemia.

The nurse is caring for a client with increased intracranial pressure. Which diuretic would the nurse anticipate being prescribed for this client?

mannitol

The nurse is caring for a client who is experiencing pulmonary edema. The client is treated with furosemide. What will the nurse monitor most closely?

potassium levels

The nurse is caring for a client with hyperaldosteronism. For which diuretic would the nurse prepare teaching for the client?

spironolactone

A client with heart failure is prescribed a loop diuretic. Which client statement indicates that teaching provided by the nurse about this medication was effective?

"I will change positions slowly if I feel dizzy."

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."

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.

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

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 40 mg PO BID

When preparing the teaching plan for a male client who is prescribed spironolactone, the nurse would alert the client to which potential adverse effect?

Gynecomastia

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?

Hyperkalemia

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

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.

The nurse is caring for a client with a severe head injury. An osmotic diuretic is prescribed. The nurse understands which drug is an osmotic diuretic?

mannitol

A 68-year-old client who has type 1 diabetes is to receive hydrochlorothiazide. Before administration of this medication, what information is most important for the nurse to communicate to the client?

Insulin doses may need to be increased.

A nurse has been assigned to patient who receives hydrochlorothiazide each morning for the treatment of primary hypertension. Which of the following components of the patient's morning blood work should prompt the nurse to temporarily hold the drug this morning and consult with the physician?

K+ 3.0 mEq/L