Diuretics

 

 

                Diuretics

                                                           

Diuretic	Features
Furosemide	.It is a potent diuretic. Its dose is 40 mg IV. .It can be given IV as well as orally. Oral dose is 40mg/day. It is given in the morning and not at night so that the patient does not have to get up in the middle of the night to pass urine. .It can lead to fluid  and electrolyte imbalance. It is combined with oral KCI therapy to prevent hypokalaemia. That can also be achieved by giving coconut water, oranges, sweet lime etc.
Chlorothiazide	.It is a diuretic for oral use. .It potentiates the effects of digitalis. Thus digitalis can be given in a lower dose and its toxic effects can be avoid. .It reduces blood pressure. .It may cause diabetes mellitus or gout when given over prolonged periods.
Spironolactone	.It has actions like the hormone aldosterone. So it spares potassium and its use is not associated with hypokalaemia. .It is expensive. .It is reserved for use when chlorothiazide is not effective.
Ethacrynic acid	.It  is a potent diuretic. .It is given IV OR Orally. .It is useful to reduce, the water content of the lungs. .It can cause hypokalaemia, and hence is used only wen the patient is hospitalized.

 

 Adverse effects of diuretics

1.Hypokalaemia:It causes weakness, tiredness.

2.Hypovolemia :It causes tiredness, low blood pressure, lowering of  blood urea  nitrogen level.

Nursing care

1.The patient’s bed is made every day.

2.Position is changed every 2 hours.

3.Care is taken of the back and the pressure points every 4 hours ,so as to prevent bed sores.

4.Oral hygiene is maintained every 4 hours.

              .cleaning.

              .Gargling.

5.Temperature, pulse, and respiration are recorded every 4 hours.

6.If the patient is receiving digoxin, the pulse is checked and the next dose is not given if the pulse rate is less than 60/ per  minute.

7.Diet is given as described before.

8.Medicines are given as prescribed.

9.Input –output chart is maintained.

10.Bowel movement is ensured  every day.

11.The weight is recorded once a week.

12.Nails are trimmed every week.

13.Hair is combed every day. It is bathed once a week.