Loop Diuretics
*Block sodium and chloride to prevent water reabsorption
*Work in the ascending Loop of Henle
*Causes extensive diuresis
Adverse Effects
Dehydration
Hyponatremia
Hypochloremia
HPTN
Ototoxicity
Hypokalemia
Decreased calcium and magnesium
| Nursing Interventions |
| Monitor lab values especially electrolytes Vital signs especially BP I &O Educate about increasing potassium in diet Monitor blood sugar levels Assess for weight loss, headache, dizziness, tinnitus, skin turgor, edema, and muscle twitching |
◊ Don’t give before bed! ◊
If used with…
- Digoxin can cause dysrhythmia
- Antihypertensives can cause HPTN
- NSAIDs decrease effectiveness
- Examples: Furosemide (Lasix) & Bumetanide (Bumex)
Thiazide Diuretics
*Works in the early distal convoluted tubule
*Blocks reabsorption of sodium and chloride
*Promotes diuresis
Adverse Effects
Dehydration
Decreased potassium
Hyperglycemia
1st choice for HTN
| Nursing Interventions |
| Monitor labs especially potassium Increase potassium in diet Vital signs Monitor weight I& O Blood sugars |
Examples: Hydrochlorothiazide & Metolazone
Potassium Sparing Diuretics
*Block aldosterone which causes in potassium retention and sodium and water secretion
Adverse Effects
Hyperkalemia
ACE inhibitors and potassium supplements increase risk for hyperkalemia
| Nursing Interventions |
| Monitor potassium levels Avoid diets increase in potassium including salt substitutes Monitor BP Urine may turn blue on triamterene |
Often used with other diuretics
Examples: Spironolactone (Aldactone) &Triamterene
Osmotic Diuretics
*Decreases intercranial pressure and intraocular pressure by increase serum osmolality which pulls fluid back into vascular and extravascular spaces
Adverse Effects
Heart Failure
Pulmonary Edema
Kidney Failure
| Nursing Interventions |
| Assess for dyspnea, weakness, JVD, and weight gain I &O Monitor labs |
Example: Mannitol (Osmitrol)
Specific Uses
Prevent patient in hypovolemic shock from going into renal failure
Decrease ICP and IOP
Used in the oliguria phase of acute kidney injury