1. The client/caregiver can define indications for the use of diuretics.
   1. Diuretics increase the volume of urine production and excretion.
   2. Along with antihypertensive medications, they are used in the treatment of hypertension and heart failure and sometimes with kidney disease.
   3. Because this type of medication affects electrolytes, it is important to maintain electrolyte balance.
2. The client/caregiver can list important medication teachings and concerns.
   1. Client will understand signs of dehydration or electrolyte imbalance.
      • Low potassium levels may be evidenced by generalized weakness and muscle cramps.
      • Dehydration may present as decreased urine output and thirst.
   2. Use a weight schedule to monitor for changes.
   3. Clients with kidney disease should be monitored more closely.
   4. A balanced diet and proper amounts of fluids are encouraged
   5. Diuretics should be taken during the day, preferably in the morning.
   6. Ambulation ability or self-care issues should be addressed because of increased urinary output.
   7. Have routine laboratory tests to evaluate electrolyte levels and liver and kidney function.
   8. Glucose and uric acid levels may increase with diuretic use. Clients with diabetes and/or gout should be monitored.
   9. Monitor blood pressure, and report any unusual changes.
   10. Avoid herbal or dietary supplements unless approved by a physician.
   11. Discuss high-potassium diets (including a teaching guide) or potassium supplements if prescribed by a physician.
   12. Discuss low-sodium diets (including a teaching guide) if prescribed by a physician.
   13. If needed, instruct how to measure intake and output.
   14. Limit exposure to sunlight due to possible side effects of photosensitivity.
   15. Consult a physician for instruction if experiencing an acute illness with fever, vomiting, or diarrhea.
   16. Restrict the use of alcohol and caffeine.

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. St. Louis: Mosby Elsevier.
Adams, M. P., Josephson, D. L., & Holland, L. N. Jr. (2005). Pharmacology for nurses: A pathophysiologic approach. Upper Saddle River, NJ: Pearson Education, Inc.
Deglin, J. F., & Vallerand, A. H. (2001). Davis’s drug guide for nurses. Philadelphia: F. A. Davis Company.
Nursing 2006 drug handbook. (2006). Philadelphia: Lippincott Williams and Wilkins.