Diuretic Therapy – Management of Ascites (Nursing)

by Rhonda Lawes

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    00:00 Our third inter professional goal is diuretic therapy.

    00:04 Now, I know in nursing school you deal a lot with diuretics, but people with ascites have a little unique twist to there, so they sometimes require some unique diuretic medication treatment plans.

    00:17 Let me explain. Look at our graphic.

    00:20 I have their one bottle of furosemide and one bottle of spironolactone.

    00:25 Now furosemide also known as Lasix, but furosemide is a loop diuretic, what type of diuretic is spironolactone? Right. It's a potassium sparing diuretic.

    00:38 Now, let me explain how we use this in ascites patients are at risk for weird electrolyte imbalances, kidney impairment, and significant changes in their blood pressure.

    00:49 So you're going to need to collaborate with a pharmacist or a pharmD, same thing, because pharmacist get a doctorate in their area of specialty.

    00:59 So collaborate with the pharmacist and the healthcare provider regarding the patient's It's to the prescribed therapy, especially with changes in medication as they're prescribed.

    01:09 So know that we don't use diuretics exactly the same with someone who doesn't have ascites in a patient that we do common diuretics that will choose to use will be furosemide and spironolactone.

    01:23 Let me give you some specific assessments that you're going to want to be aware of as a nurse taking care of patients with ascites on diuretic therapy.

    01:31 You're going to monitor their lab work routinely and with any changes in diuretic therapy, so look at their serum electrolytes sodium potassium chloride and bicarbonate.

    01:42 Okay.

    01:44 I want to pause to make sure you don't let that list rush right by you.

    01:48 You want to make sure that you monitor their sodium, potassium, chloride, and bicarbonate.

    01:55 You these are lab values that are critically important to any patient.

    02:00 And universally these show up on nursing exams and the NCLEX.

    02:04 So make sure you know the normals for each one of those electrolytes and the signs and symptoms.

    02:10 So it's important to know the numbers but it's also important for you to know the clinical signs and symptoms of electrolyte imbalances particularly depletion.

    02:19 So we're thinking about cardiac dysrhythmias, muscle cramps, weakness, lethargy, confusion.

    02:25 Make sure you recognize which of these symptoms or complaints a patient may express to you line up with depletion of these important electrolytes.

    02:35 Monitor the patient's kidney function.

    02:38 Look at the BUN, the blood urea nitrogen and serum creatinine levels.

    02:43 Keep an eye on those because those could be indicator your patient is over dehydrated or the kidneys are starting to struggle.

    About the Lecture

    The lecture Diuretic Therapy – Management of Ascites (Nursing) by Rhonda Lawes is from the course Liver Cirrhosis (Nursing).

    Included Quiz Questions

    1. Sodium level
    2. Bicarbonate level
    3. Potassium level
    4. thyroid panel
    5. Troponin level

    Author of lecture Diuretic Therapy – Management of Ascites (Nursing)

     Rhonda Lawes

    Rhonda Lawes

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