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 response
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.