Diuretics

Overview

Diuretics are medications designed to increase the excretion of water and electrolytes by the kidneys. They are primarily used to treat conditions involving fluid volume excess, such as congestive heart failure, renal disease, and hypertension. The nursing focus is on monitoring fluid and electrolyte balance and assessing for the therapeutic effect of reduced edema and blood pressure.

Key nursing concepts

• Diuretics increase urine output to reduce fluid volume in the body.
• Loop diuretics like furosemide are potent and cause significant potassium loss.
• Thiazide diuretics are often used as first-line treatment for hypertension.
• Potassium-sparing diuretics block aldosterone but can cause hyperkalemia.
• Osmotic diuretics like mannitol are used to reduce intracranial pressure.
• Diuretics are commonly used to treat heart failure, hypertension, and edema.

Important nursing considerations

• Monitor daily weights as the most accurate indicator of fluid loss.
• Assess for signs of dehydration such as poor skin turgor or dry mucous membranes.
• Evaluate serum potassium levels, especially for loop and thiazide diuretics.
• Monitor blood pressure, as diuresis reduces circulating blood volume.
• Administer the medication in the morning to prevent nocturia and sleep disturbance.
• Assess for edema in the extremities and auscultate for lung crackles.

Patient teaching

• Take the medication in the morning to avoid waking up at night to urinate.
• Increase intake of potassium-rich foods if taking a loop or thiazide diuretic.
• Avoid salt substitutes if taking a potassium-sparing diuretic.
• Weigh yourself daily at the same time and in the same type of clothing.

Related practice questions

Real questions from the NursGuru bank, each with the answer and rationale.

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