Pharmacology Antihypertensives #10

Question

The nurse is caring for a client who is prescribed hydrochlorothiazide for hypertension. Following administration of this medication, the nurse should anticipate what effect?

Answers

  1. Increased blood pressure related to increased cardiac output
    • Rationale:

      This answer is not correct because decreased blood pressure (not increased blood pressure) will occur when HCTZ is taken. Hydrochlorothiazide (HCTZ) is a thiazide diuretic prescribed to cause diuresis in clients needing decreased fluid in the body that causes hypertension and edema.

  2. Increased urine output related to diuretic effect
    • Rationale:

      This answer is correct because increased urinary output reflects the effectiveness of HCTZ’s excretory action. Hydrochlorothiazide (HCTZ) is a thiazide diuretic prescribed to cause diuresis in clients needing decreased fluid in the body that causes hypertension and edema.

  3. Elevated potassium
    • Rationale:

      This answer is not correct because decreased potassium (not elevated) occurs when a client takes HCTZ. After HCTZ causes sodium to be excreted in the distal part of the convoluted tubule, potassium and bicarbonate is also excreted. Electrolytes (particularly potassium) should be monitored carefully in clients so balance is maintained in the body.

  4. Mild agitation
    • Rationale:

      This answer is not correct because mild agitation is not a common side effect of HCTZ. Increased urinary output, decreased blood pressure, and decreased sodium and potassium are the most common side effects of HCTZ.

Overview

Hydrochlorothiazide (HCTZ) is a medication used to treat a client needing reduction of fluid blood volume and/or blood pressure by means of diuresis.

Explanation

Hydrochorothiazide is prescribed for management of mild to moderate hypertension and edema. Therapeutic effects occur with lowering of blood pressure and diuresis for mobilization of fluid volume. Therefore, increased urine output related to the diuretic effect will occur. The drug may cause a decrease in potassium, not an increase (as in spironolactone, a potassium sparing diuretic). Mild agitation is not a common adverse reaction.

Learning Outcomes

Hydrochlorothiazide (HCTZ) is a thiazide diuretic prescribed to cause diuresis in clients needing decreased fluid in the body that causes hypertension and edema. HCTZ decreases the ability of sodium to transport in the distal part of the convoluted tubule. Increased amounts of sodium is thereby excreted and the fluid follows the sodium leaving the body. After sodium is excreted, potassium and bicarbonate is excreted. Increased urinary output reflects the effectiveness of HCTZ but electrolytes should be monitored carefully in clients so balance is maintained in the body.

Test Taking Tip

The two major things to check before administration of most diuretics (potassium sparing or potassium wasting) are the blood pressure and potassium levels.

Video Rationale