What are the important nursing precautions when dealing with clients taking diuretics? What are the necessary things that you need to remember when giving diuretics to a client?
To answer those questions, we’ll give you a rundown of some signs and symptoms of diuretics and what you have to watch-out-for as the nurse in charge for clients who are taking diuretics.
To easily remember the necessary nursing precautions, keep in mind the acronym DIURETIC, which stands for:
- Input and output with daily weights
- Unbalanced fluid and electrolytes
- Ready for decreased blood pressure and increased heart rate
- Evening dose is a no-no.
- Take AM
- Increased orthostatic hypotension
We’ll be discussing each nursing precaution and some of the helpful test question favorites.
Specifically, with loop diuretics, you have to make sure that the client has a diet that is high in potassium. Loop diuretics are potassium-wasting diuretics, which mean that they deplete potassium from the body and into the potty. For this reason, it is critical that you instruct your client to consume foods that are high in potassium and some examples are:
- Green, leafy vegetables
Reminder: Diet is a test question favorite. Most of the questions regarding Lasix would revolve around questions like, “A client is on Lasix, what kind of diet should you recommend?”
The answer is a high potassium diet.
Input and Output
Monitoring the input and output (I/O) of a client taking diuretics is vital because usually, these clients are on fluid restriction.
On most occasions, family members are eager to bring their loved ones their favorite foods during hospitalization; however, they are not allowed to consume anything that is high in sodium and potassium, especially those who are taking potassium-sparing diuretics. Therefore, input restrictions have to be made with clients on diuretics.
In scenarios like this, education is necessary to let the client and family members understand that the reason why we give diuretics is to keep the fluid out of the body, and certain foods retain fluid in the body.
Aside from checking the input and output, getting the daily weight is also a huge factor with clients on diuretics. A lot of nurses miss this important step nowadays. Doctors would want to know how much the client weighed when they first came in and on a day-to-day basis to evaluate how well the diuretics are working.
Unbalanced Fluid and Electrolytes
As previously mentioned, clients who are taking diuretics would have problems with their sodium and potassium levels; therefore, as the healthcare provider, you can expect unbalanced fluid and electrolytes.
Ready for Decreased BP and Increased HR
It is expected that blood pressure will drop and the heart rate will increase at any time due to the effects of diuretics. There will be less pressure with regards to the vascular spaces, and at the same time, the heart rate will skyrocket, so you have to monitor the client for those two things closely.
Evening Doses are a No-No
Never give diuretics in the evening. You don’t want your clients to fall on the ground or trip themselves when going to the restroom.
To prevent the risk of falling, diuretics are given only in the morning. Take note of this detail because this is another test question favorite.
Increased Risk for Orthostatic Hypotension
Medically termed as syncope, orthostatic hypotension is also known as the fainting spell which happens when clients change their positions too quickly. This is a safety concern and is tagged as a fall precaution in the hospital.
Looking out for orthostatic hypotension is important in adding plan of care for the client and putting them on fall precaution.
To complete our DIURETIC acronym, we’ve included cigarettes as one of the things to avoid when taking diuretics. Obviously, cigarettes are contraindicated and are considered as risk factors for nearly every diagnosis.
That’s it for nursing precautions when giving diuretics. For more helpful information like this, visit our SimpleNursing website and YouTube channel.