Diuretic Therapy – Management of Ascites (Nursing)

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.