UTIs
List two risk factors for a UTI.
Females with shorter urethras and frequent catheterization.
Benign Prostatic Hypertrophy (BPH) is treated with two drug classes. List the drug classes and mechanism of action.
Alpha-adrenergic blockers and Testosterone production blockers.
Shrink the glad/or relax the sphincter of the bladder
What is the mechanism of action of a thiazide diuretic?
Block the chloride pump in the distal convoluted tubules and lead to a loss of sodium and potassium and a minor loss of water.
Give an example of an osmotic diuretic.
Mannitol
What are the adverse effects of potassium sparring diuretics?
Abdominal cramping, confusion, irregular heart rate, nausea,vomiting, and fatigue.
Obstruction, Sexual Abuse, Bubble Baths, Congenital birth defects, Diabetes, and Immunodeficiencies.
What are the adverse effects of urinary
antispasmodics?
Related to the blocking of the parasympathetic nervous system (anticholinergics); can't see, can't pee, can't spit, can't ****.
What are the most common nursing interventions associated with diuretic administration?
Ensure fluid intake is adequate
Monitor uric acid levels since the medication can increase uric acid
Daily weights
Assessing for edema
Monitoring input and output
Monitoring potassium levels
Safety measures due to the risk of hypotension
Osmotic diuretic - Nursing Interventions
Assess the skin for signs of edema
Monitor the blood pressure due to the risk of hypotension
Monitor for signs of CNS toxicity
What drugs interact with Spironolactone?
Some antihypertensive medications and salicylates. When combined with a salicylate it decreases the effectiveness of the diuretic and increases the risk of hypotension. When combined with ARBs and ACEIs it increases the risk of hyperkalemia.
List a contraindication for phenazopyridine and what should the nurse include when educating the patient who is taking phenazopyridine?
Contraindication - Renal Insufficiency
Patient Education - Instruct the patient to report any yellowing of the eyes or skin to their provider and it is normal for the urine to be a reddish-orange color.
Which class of diuretics is used first in the treatment of hypertension?
Thiazide diuretics
Loop diuretics - which labs do we monitor?
Potassium, calcium, and glucose levels
Give an example of a carbonic anhydrase inhibitor and what is it used for?
Acetazolamide
Glaucoma
What is the purpose of urine culture and sensitivity testing?
A urine culture looks for bacteria that cause UTIs. If you have a UTI, an antibiotic sensitivity test can pinpoint the bacteria. This information helps your healthcare provider choose the best medicine to clear up your infection.
What are the signs of hypokalemia?
Fatigue, weakness, and muscle cramps
Thiazide diuretics - Adverse Effects
Hypotension, dizziness, nocturia, muscle cramps
Acetazolamide - Drug Interactions
Lithium
Salicylates
Dutasteride and pregnancy risk factors.
Dutasteride can be absorbed through the skin and cause birth defects in male fetuses.
Patients who are treated with alfuzosin for BPH should be instructed to monitor for the following...
Bleeding, headache, alopecia, GI disturbances
Increased IOP, blood pressure, and incomplete bladder emptying
Thiazide diuretics - Drug Interactions
Loop Diuretics - Drug interactions
Thiazide Diuretics
Digoxin - increased risk for toxicity due to changes in potassium levels
Antidiabetic agents (Insulin) - decreased effects of antidiabetic agents
Lithium - increased risk of lithium toxicity
Loop Diuretics
Gentamicin - ototoxicity
Anticoagulants - effects may be increased
NSAIDS - ibuprofen, naproxen, salicylates etc.
Digoxin
Lithium
Cholestyramine can be given to patients taking HCTZ but the drugs should be given at least two hours apart!