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Last d is for diuretics which diurese fluid or drain the fluid from the body and into the potty this guy is the number one drug we use for acute or worsening heart failure big nclex tip so remember the ds diuretics decrease the blood pressure by draining the fluid or diary seing the fluid to dehydrate our heart failure patients with heavy fluid now we have
Potassium wasting and potassium sparing diuretics potassium wasting ends in i’d like furosemide or hydrochlorothiazide both rhyme with dried but again be careful not ice soso abide that’s a nitrate guys the nclex will try and trick you so remember the o’s and iso so make it a vasodilator similar to nitro now loop diuretics like furosemide and torse amide are the
First drugs we use in acute or that worsening heart failure so nclex keywords like worsening crackles new edema in the legs and even rapid weight gain guys we give ides to make the body tried these guys work by blocking the reabsorption of sodium in the kidneys so with less sodium retained we have less swelling retained and our patient is saved now we only get
Potassium wasters if potassium is normal between 3.5 and 5.0 anything less than 3.5 is a big no-no guys we don’t give the drug so we encourage our patients to eat melons bananas green leafy veggies and even liver and a big no-no here we avoid a licorice root which lowers potassium like those found in black licorice candy that’s a common select all that apply
Question so just remember the double ells here licorice lowers potassium now potassium sparing diuretics s4 spironolactone just think s4 spares the potassium just like prills and sartain this spares potassium too but instead of blocking the angiotensin this guy blocks aldosterone directly to let fluid out of the body and into the potty and ends in tone so
Think it blocks aldosterone since verona lactone spares the potassium we teach patients to avoid those potassium rich foods guys so we don’t eat those green leafy veggies those malins avocados and we avoid that salt substitute and again and again any potassium abnormality the first nursing action is to place them on a cardiac monitor always asked on the nclex
And exams as a priority intervention lastly since potassium pumps the muscles and clicks key words like muscle spasm and even muscle cramps this indicates a potassium problem even words like weakness or paresthesias so with potassium wasters that low or potassium think low pumps in the heart we get flat t-waves and st depression and also this little weird you
Wave now a little side note if you have to replace potassium via iv well guys don’t kill your patient we never push potassium iv this means instant death we always give it iv bag over an hour or more guys never thirty minutes and not even 45 minutes one hour or more typically four hours and with our sprung a lactone which spares potassium we get high potassium so
Think high pumps with peaked t waves and even st elevation in severe hyperkalemia now for other killer nursing considerations guys these three show up a lot on nclex exams so guys before we give you diuretics always check the bp b for blood pressure you hold the medication for low blood pressure anything less than 100 systolic b for b un and creatinine the kidney
Labs we always check before giving since it can hurt the kidneys by giving too much or too quickly and again the p for potassium imbalances since p pumps the heart we always put the patients on the cardiac monitor then we watch for muscle spasms or cramps and even weakness and paresthesias big nclex tips now finally five general diuretic and clicks tips always on
Static questions number one take in the morning not at night this med drains fluid so we want potty breaks all the time during the night second this med makes patients dizzy so slow position changes to avoid feigning aka that orthostatic hypotension also called postural hypotension third daily weights not weekly but daily always reporting two to three pounds or
More remember weight gain usually means water game so maybe we need to increase their dose for is risk for sunburns so just use sunblock and finally low sodium diet since sodium swells so guys again no chips no fried foods like deep fried chicken or even deep fried ice cream definitely no french fries and even no canned foods or packaged foods like cheese wines
Meats and even fast food and again avoid those over-the-counter meds like can so guys cough and flu meds anti acids like tums as cinnamon afine like tylenol and nsaids like ibuprofen and naproxen guys all these contain high amounts of sodium which swells the body now a little side note about furosemide our loop diuretic we already know it’s the number one drug
For worsening heart failure right but caution if given too fast it can be ototoxic meaning ear pain or ringing in the ears called tinnitus and even hypotension that low blood pressure but guys not not bradycardia never low heart rate and if given too much over the long term it can cause nephrotoxicity meaning kidney toxic with high b un and high creatinine so
Always check the two labs to protect those two kidneys and as you know hypokalemia that low potassium below 3.5 for those long term doses not usually affected by fast administration alright guys that wraps it up now don’t forget to see our eight question cardiac quiz and test your knowledge in our quiz bank thanks guys thanks for watching for our full video &
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Transcribed from video
Pharmacology – Diuretics (Loops, Thiazide, Spironolactone) for Registered Nurse RN & PN NCLEX By Simple Nursing
