Review: Diuretics (Nursing)

00:00 Hi. Welcome to the video in our diuretic series. We're going to talk about thiazides and potassium-sparing diuretics and mannitol. Okay, so let's just kind of review quickly what diuretics do. They increase the kidneys' output of urine because we're trying to lower blood pressure or decrease edema. Now, both of those are really good things for our patients. If they have high blood pressure, we give them a diuretic, they put off that extra fluid, they'll have less volume in their intravascular space. That means with less volume in their intravascular space, you know all your blood vessels, their blood pressure will be lower. Also if a patient has edema, that's just a way of saying that fluid is not where we want it to be. They've got too much fluid or it shifting into their tissues, a simple example might be someone as like those swollen ankles or you press on their shins and they have edema there. We want to remove that. So diuretics can help us do that.

00:55 So when you're thinking about what types of patients do we give these to, we're going to give it to someone who either their blood pressure is a little high when we want to drop that down or someone that we want to decrease edema. Now this is just a quick review of the nephron.

01:09 Remember, each one of your kidneys has a million of these nephrons. I think it is so amazing.

01:16 Now we've got a cool picture for you there. You can see the glomerulus. Remember that's that tangle of capillaries and it's surrounded by Bowman's capsule. As your blood goes through there, it squishes out the solutes and all that stuff into the filtrate that filters through the rest of the nephron. The nephrons go from the cortex to the medulla of the kidney. Now the nephron has those 3 parts. We just talked about the first couple ones. Right? The glomerulus and the Bowman's capsule.

01:40 They also got the tubules and we have the names for you there. So that's just a quick review.

01:45 We know what diuretics do. We're trying to get rid of excess fluid or edema. They'll also lower a patient's blood pressure and we're going to talk about the nephrons because that's where the diuretics work. They've got those 3 parts; the tubules, the glomerulus which is that tangle of capillaries, and the Bowman's capsule. Okay, this is a familiar drawing for you if you seen some of our other videos on diuretics, but this is if we just kind of stretch that nephron out so you can see how it works. Now just start right at the top. You kind of put your finger or your pencil on where the glomerulus is. Right? That's the capillaries surrounded by Bowman's capsule and then it goes through to the tubules. Okay, so you can see as it goes all the way if you trace that down. You have the collecting duct and where urine is excreted. So you've taken 1 little nephron and stretch it out for you to see what the parts are that make it up. Now in the pink boxes you'll see we've got carbonic anhydrase inhibitor. That's a type of diuretic. You'll see in another box, loop diuretic, closer to the bottom, more on the medulla where we have the box located. You've got thiazides at the top and potassium-sparing diuretics over on the right. Okay, we have those there because this is just kind of a reminder to let you know that wherever this diuretic works that kind of let us know how strong or how potent these drugs are going to be. The closer you are to the glomerulus, the stronger the effect. So, loop diuretics are stronger than thiazide diuretics, thiazide diuretics are kind of have a bigger impact as far as fluid loss, then potassium-sparing diuretics. Now, it says K+, that just stands for potassium. So potassium-sparing diuretics and thiazides are some of the diuretics we're going to talk about in this series.