24. Mr. E. has been admitted for treatment of ascites. He also has some renal im
ID: 125840 • Letter: 2
Question
24. Mr. E. has been admitted for treatment of ascites. He also has some renal impairment and a history of heavy drinking. a. Which diuretic drug will the nurse expect to be CASE Read th question administered to Mr. F.? b. What monitoring will be performed frequently?y ant Lily has she is c muscle is 100/5 25. Brendan, a 39-year-old bricklayer, is taking a thia zide diuretic for hypertension. During a follow-up visit, he tells the nurse that he thinks the drug is af- fecting his "love life. a. To what adverse effect of thiazide therapy is 1. Wha hap Brendan probably referring? b. While the nurse is talking, she notices a package 2. ver of licorice in Brendan's coat pocket. He tells her that he eats the candy "for energy," especially be 3. Th tor fu cause he has been feeling so tired the past couple of days. What will the nurse tell Brendan? 26. The nurse receives a call from Mrs. H., who re- 4. Y cently started diuretic therapy for hypertension. Mrs. H. is concerned because her neighbor, who also takes medication for hypertension, has told her not to eat a lot of bananas or other foods containing potassium. "But you told me to eat foods high in potassium," Mrs. H. says to the nurse, "What's going on?" What will the nurse respond to Mrs. H.? 27. Mrs. P. will be started on diuretic therapy for hy- pertension, but she also has moderate renal failure. Which diuretic-a loop diuretic or a thiazide diuretic-would be more effective for Mrs. P.? Explain your answer.Explanation / Answer
24.
a) The nurse will administer a loop diuretic to Mr. F.
Loop diuretics inhibit the reabsorption of sodium at the ascending loop in the nephron resulting in excretion of water in the urine. This will excrete sodium from the body, which will reduce the fluid collection in peritoneal cavity (Ascites).
b) The nurse will frequently assess for pedal oedema, hyponatremia and azotaemia. Loop diuretics can induce electrolyte imbalances, hypokalaemia (in case of furosemide), hyperkalaemia (in case of Spironolactone) and hyponatremia are common.
Other complications like renal failure, severe muscle cramps or worsening hepatic encephalopathy will be assessed by nurse and discontinue the diuretic in such cases.
25.
a) Brendan is probably referring to sexual dysfunction that is one of the side effects caused by thiazide diuretics.
b) Licorice is said to have possible dangerous interaction with thiazide diuretics. Licorice can increase the potassium depletion caused by thiazides which can contribute to serious imbalances in potassium levels in the body (may lead to severe hypokalaemia). This may also be one of the reasons for sexual dysfunction.
26. The nurse will explain the effects of diuretics to Mrs H.
The diuretics promote diuresis or increase the output from kidney. With increase in excretion of sodium the water excretion also increases. The loop diuretics and thiazide diuretics increase the potassium loss from distal tubule, potentially causing hypokalaemia. Another class of diuretics known as potassium sparing diuretics, do not cause hypokalaemia unlike loop and thiazide diuretics. In such cases the potassium is retained in the body and chances of potassium level imbalances is less with such diuretics.
Mrs. H may be prescribed loop or thiazide diuretics as treatment which has potential to cause hypokalaemia, hence she has been advised to eat foods containing potassium.
27. Thiazide diuretic therapy is recommended as first line treatment for hypertension. These inhibit the sodium chlorine symporter which causes retention of water in urine. It also decreases preload further decreasing the blood pressure. The vasodilating effect also decreases the blood pressure by decreasing the resistance.
Related Questions
drjack9650@gmail.com
Navigate
Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.