Direct routes of diuretics to administer to the patients are by mouth (PO), IV, and IM. There are loop diuretics and thiazide diuretics that you can mix up, but it’s important to know the difference!
Loop diuretics:
- Inhibits sodium and chloride reabsorption directly and it occurs in the ascending loop of Henle
- Also occurs in the proximal and distal tubules.
Thiazide diuretics:
- Acts mainly in the distal tubules.
- Also inhibits sodium and chloride reabsorption.
What diuretics are used for:
- Edema; helps to get rid of extra fluid volume in the body
- Hypertension (Extra fluid in body can cause hypertension)
Don’t give diuretics to patients who:
- Pregnant, breastfeeding
- Severe adrenocortical impairment, anuria, progressive oliguria.
Be cautious in giving diuretics to patients who have:
- Fluid and electrolyte depletion
- Gout
- Patients taking digitalis, lithium, NSAIDs, and anti-hypertensive medications.
Side Effects:
- Dehydration, hyponatremia, hypochloremia, hypokalemia
- If you’re removing fluid, you’re removing electrolytes.
- Tiredness, weakness, dizziness
- Weak pulse, orthostatic hypotension
- Tinnitus, hyperglycemia, hyperuricemia, hearing loss (caused by Lasix)
Nursing Implication:
- Monitor intake and output.
- Monitor potassium loss.
- Monitor weight and vital signs (Watch for blood pressure).
- Monitor for hearing loss (most likely temporarily, lasts 1 hour to 24 hours).
- Teach patient to take medication early in the day to reduce chances of nocturia.
- Teach patient to report hearing loss or gout symptoms.
