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How three main types of Diuretics work… including powerful LOOP DIURETICS, must know medications.

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Diuretics we’re going to cover three main types of diuretic loop diuretic thiazide diuretic and potassium sparing diuretic the all diuretic works on kidney and spatially nephron which is a functional unit of kidney we’re going to talk in detail about each diuretics mechanism of action or their side effects in which disease condition we use in the nursing consideration

Okay so let’s talk about first loop diuretic mechanism of action okay so this is the diagram representing nephron and which is the functional unit of kidney and all the blood filtration formation of urine reabsorption and excretion of the all the electrolytes happen in this nephron however we are interested in the reabsorption and excretion of sodium potassium and

Water now before we go into the mechanism of action of loop diuretic like and let’s understand a some part of the nephron and where the sodium and potassium reabsorption acts creation occurs so first of all proximal convoluted tubules where about 65 to 70 percent 65 to 70 percent of sodium gets reabsorbed there is no direct at works in works here so 65 to 70 percent

Of sodium is gonna get reabsorbed no matter what diuretic we gave however this is called descending loop of henle this is loop of henle and this is ascending loop of henle now we are interested in ascending loop of henle in ascending loop of henle there is a pump it’s called an e plus k plus 2cl – now this point what what it does it uses the energy uses energy

To reabsorb sodium potassium and chloride back to the blood now when sodium gets reabsorbed waters gonna follow sodium so what is gonna get reabsorbed as well in ascending loop of henle now here about 25 percent approximately sodium gets reabsorbed using this pump which uses the energy as well now loop diuretic inhibits the whole pump loop diuretic inhibits this

Whole reabsorption process when the sodium doesn’t get reabsorbed but as jim doesn’t get reabsorbed and chloride doesn’t get reabsorbed what is not gonna get reabsorbed as well and when water doesn’t get reabsorbed so if you look at it here right the ascending loop of henle it’s gonna go to from here to the collecting ducts and from there it’s gonna get x created

Screw through urine so sodium water and potassium and chloride they’re all gonna get x create date through the collecting ducts without gets reabsorb since lubed addicts gonna inhibit pump since we understood that mechanism for action of the loop diuretic let’s just talk briefly what it does on the on the on nephron and spatially more in detail like a sending loop

Of henle and if we if we know this three main mechanism of action of this loop diuretic we’ll be able to understand the side effects and also the nursing consideration as well so it prevents the reabsorption of sodium water potassium and chloride okay now indication because of this it excretes the water it can be used for it for the prevention of edema we can use

This medication to prevent the edema they had that happens in the heart failure pulmonary edema hepatic failure or hepatic cirrhosis are chronically renal failure this medication is also used to treat hypertension especially she russa mine also we killed this one as a lasix or water pill this particular drug physician uses plan often to treat hypertension as well

The next leg we’re going to talk about the side effects nursing consideration and contraindication now as we talked the mechanism for action it affects many electrolyte reabsorption in kidney so it first side effects is electrolyte imbalance which the first one is causes hyponatremia now when we could when we cover lithium medication which is bipolar medication

We’ll go over why the hyponatremia can cause the lithium toxicity but like since this medication can cause the hyponatremia and if a patient on lithium medication for bipolar that can cause serious lithium toxicity it can cause since the hyponatremia because of the hyponatremia can cause the central nervous system changes such as headaches changes in level of

Consciousness so we have to look for those symptoms as well another electrolyte imbalance is a hypokalemia now due to the low potassium level now normal potassium level is three point five to five point two okay so usually if hypokalemia is lower than three point five now it can cause the cardiac arrhythmia and also the digoxin toxicity also we will talk about

Digoxin within cardiac glycoside slides now digoxin toxicity can happen when there is a low potassium level in the body so you have to look for the digoxin toxicity as well and this finally can cause the hypokalemia which is low chloride level so if you go back to the mechanism of action slide and if you look over it remember we talked about that it prevents the

Reabsorption of sodium potassium and chloride so it’s kind of self-explanatory that why this medication can cause the hyponatremia hypokalemia and hypo call history mia now also as a nurse if a patient on this medication you want to monitor the electrolytes sodium potassium chloride magnesium and calcium okay this medication also can cause significant hypotension

And that’s why you have to teach the patient about their side effects like fainting and dizziness and since this stroke also excrete significant amount of water and causes deressa we had to teach patient to look for the signs and symptoms like thirst dry mouth significant weight loss lowering outputs usually less than 30 ml per hour this medication also can cause

The auto toxicity and one of the sign is one of the signs of the auto toxicities tinnitus so you had to look for which is basically ringing in the ears okay so what we have to teach patient and what a nursing consideration so first of all had to tell patient to eat high potassium foods because it’s causes the hypokalemia such as bananas potatoes or whatever would

Like the high potassium call containing foods i had to tell them like monitor for signs and symptoms of hypokalemia such as nausea vomiting and generalized weakness as well they have we had a column monitored their blood pressure daily okay and avoid using other ototoxic medications such as gentamicin and since this one can cause this medication can cause sudden

Change in blood pressure and can cause the hypotension we have to educate patient that to avoid certain changes in the position rising slowly from lying position to sitting and so forth they can’t let’s just changed their position suddenly because it can cause significant decrease in high blood pressure and can cause the diziness so what are the examples of loop

Diuretic the first one is furiosa mind which is widely used doris m i’d pew me tonight and at the chronic si i haven’t seen this medication used quite often in patient i’ve seen the furious mi tend be mean and i because pima tonight is a really strong loop diuretic compared to fewer semi so if they really need a huge amount of diuresis they they prefer to use

Bumetanide compared to fewer say mine so that’s a nice thing to remember if you’re if you’re on the if you’re working on the floor and kind of wondering like why they’re using be made and i’d come a set up for us in mind it’s because of they need a i’m out of diuresis thanks for watching another nursing comm lesson click the link below in the description to watch

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How three main types of Diuretics work… including powerful LOOP DIURETICS, must know medications. By NURSINGcom