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Chapter 29 - Learning Outcomes and Activities

The document discusses diuretic drugs used to treat conditions like hypertension and heart failure. It provides learning objectives about kidney anatomy and physiology, how diuretics work to lower blood pressure, and the different classes of diuretics. It lists specific diuretic drugs like furosemide, hydrochlorothiazide, and spironolactone that should be understood. Two case studies are included about patients being treated with spironolactone and furosemide and the monitoring and education needed.

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XiaoDucky
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77 views2 pages

Chapter 29 - Learning Outcomes and Activities

The document discusses diuretic drugs used to treat conditions like hypertension and heart failure. It provides learning objectives about kidney anatomy and physiology, how diuretics work to lower blood pressure, and the different classes of diuretics. It lists specific diuretic drugs like furosemide, hydrochlorothiazide, and spironolactone that should be understood. Two case studies are included about patients being treated with spironolactone and furosemide and the monitoring and education needed.

Uploaded by

XiaoDucky
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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29 Diuretic Drugs

LEARNING OBJECTIVES
1. Describe the normal anatomy and physiology of the kidney.
2. Briefly discuss the impact of the kidney on blood pressure regulation.
3. Describe how diuretics work in the kidney and how they lower blood pressure.
4. Distinguish among the different classes of diuretic in regard to mechanisms of actions, indications,
dosages, routes of administration, adverse effects, toxicities, cautions, contraindications and drug
interactions.
5. Develop a collaborative plan of care that includes all phases of the nursing process for patients
receiving fluid and electrolyte solutions.

READING
Read the full chapter except:
 p. 487 Carbonic Anhydrase Inhibitors
 Special Populations: Children
 Special Populations: Older Adults

DRUG PROFILES/ DRUGS TO KNOW


Furosemide p. 489
Hydrochlorothiazide p. 494
Spironolactone p. 492

LEARNING ACTIVITY

1. Peter has been admitted to the nurse's unit for treatment of ascites. He also has some kidney
impairment and a history of drinking 6-10 glasses of scotch a day.
a. Which diuretic drug will the nurse expect to be administered?
b. What monitoring will be performed frequently? Why?
2. Byron is a 39-year-old bricklayer taking a thiazide for hypertension. During a follow-up visit, he tells
the nurse that he thinks the drug is affecting his "love life."
a. What adverse effect of thiazide therapy is Byron probably referring to?
b. While talking to Byron, the nurse notices a package of licorice in Byron's coat pocket. Byron
tells the nurse that he eats the candy for "energy," especially because he has been feeling
so tired the past couple of days. What will the nurse tell Byron?
3. The nurse receives a call from Barbara, who recently started diuretic therapy for hypertension.
Barbara is concerned because her neighbour, who also takes medication for hypertension, told her
not to eat a lot of bananas or other foods containing potassium. Barbara says, "But you told me to
eat foods high in potassium. What's going on?" What is the nurse's response to Barbara?
4. Paula will be started on diuretic therapy for hypertension, but she also has moderate renal failure.
Which diuretic— a loop diuretic or a thiazide diuretic—would be more effective for Paula? Explain
your answer.
Case Study #1
Shania is seeing her nurse practitioner today for a follow-up appointment. Two weeks ago, Shania was
seen for complaints of occasional headaches. On that visit, Shania’s blood pressure was 160/110 mm
Hg. Shania has been monitoring her blood pressure for the past 2 weeks, and it has remained at
150/100 mm Hg or higher. Shania is not overweight, does not smoke, and walks for exercise at least
three times per week. The nurse practitioner decides to start Shania on therapy with spironolactone
(Aldactone) daily to control Shania’s hypertension.

1. What is the role of spironolactone in the treatment of hypertension?


2. The patient asks the nurse what dietary changes, if any, she will need to make. How will the nurse
respond?
3. As the patient is leaving the office, the nurse overhears her talking on the phone. She says, “I’m
having terrible cramps. I can’t wait to get home and take some Tylenol.” Is any further patient
teaching necessary?
4. The patient calls into the clinic the following week and tells the nurse she is having a lot of diarrhea,
and her legs are so weak that she is having trouble putting one foot in front of the other. She has
been so irritable that her husband insisted she call in. What would the nurse suspect is occurring?

Case Study #2
Lenore has been taking furosemide (Lasix) for 3 months as part of her treatment for heart failure.
Now she is complaining that she is feeling tired and that she has muscle weakness and no appetite.
Her blood pressure is 100/50 mm Hg.

1. What do her symptoms suggest? How did this condition occur?

2. What dietary measures could have prevented these problems?

The physician switches Lenore's medication (see above) to spironolactone (Aldactone).

3. How does this drug differ from furosemide?

4. For what drug interactions should the nurse check before Lenore begins taking spironolactone?

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