Diuretics Practice Questions and NCLEX Review

Introduction to Diuretics

• Diuretics: Substances that promote diuresis (increased urine production).
• Function: Alter electrolytes reabsorption, excretion, and fluid volume.
• Benefits: Lower blood pressure, reduce sodium levels, prevent heart attacks and strokes.

Types of Diuretics

Thiazide Diuretics

• Mechanism: Block reabsorption of sodium and chloride ions in distal tubule.
  • Promotes natriuresis (sodium excretion) and diuresis (increased urine).
• Uses:
  • Hypertension, Congestive heart failure, Fluid retention, Chronic kidney disease.
• Nursing Interventions:
  • Monitor blood pressure, pulse, I&O ratios, daily weight.
  • Avoid abrupt dosage changes.
  • Encourage fluid intake.

Loop Diuretics

• Mechanism: Inhibit sodium reabsorption in the loop of Henle and convoluted tubules.
  • Increases urine production.
• Nursing Interventions:
  • Monitor blood pressure, pulse, I&O ratios, daily weight.
  • Avoid abrupt stopping unless advised by a healthcare provider.
  • Educate on avoiding alcohol and non-prescription drugs.

Potassium-Sparing Diuretics

• Mechanism: Block effects of aldosterone on distal renal tubules.
  • More sodium excretion, less potassium loss.
• Uses: Treat high blood pressure, heart failure.
• Nursing Interventions:
  • Monitor blood pressure, pulse, I&O ratios, daily weight.
  • Avoid abrupt stopping unless advised by a healthcare provider.
  • Educate on avoiding alcohol and non-prescription drugs.

Osmotic Diuretics

• Mechanism: Increase osmotic pressure in kidney filtrate.
  • Prevents water reabsorption, increases urine and solute excretion.
  • Reduces brain and eye pressure.
• Nursing Interventions:
  • Monitor serum potassium and electrolyte levels.
  • Assess for signs like anorexia, muscle weakness, numbness, confusion, excessive thirst.

Conclusion

• Diuretics play a vital role in controlling blood pressure and reducing fluid overload.
• Different classes of diuretics act on various parts of the nephron to achieve desired clinical outcomes.
• Nursing interventions are crucial for safe administration and monitoring of diuretic therapy.

Sources

• Mayo Clinic
• Clinical Journal of the American Society of Nephrology