INDEX Generic Trade Name Name hydrochlorothiazide Thiazide Peak Onset 3-6 hr 2 hr Why is your patient taking this medication

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NURS 2236 Clinical Form 3: Clinical Medications Worksheet (You will need to made additional copies of these forms) Classification Dose Route Time/Frequency antihypertensive 12.5mg PO daily (initial) diuretic 12.5-100mg PO 1-2 doses up to 200mg daily 50mg PO not to exceed 50mg/day for hpertension Duration 6-12 hr For IV meds, compatability with IV drips and/or solutions

Mechanism of action and indications Management of mild to moderate hypertension Treatment of edema associated with CHF, Renal dysfunction, Cirrhosis, Corticosteriod therapy, Estrogen therapy. Lowering of blood pressure in hypertensive patients and diuresis with mobilization of edema.

Interactions with other patient drugs, OTC, or herbal medicines (ask patient specifically) antihypertensives, alcohol, nitrates, corticosterioids, amphotericin B, piperacillin, ticarcillin, lithium cholestyramine, colestipol, digoxin, NSAID's, allopurinol, licorice, stimulant laxative herbs (aloe, cascara sagrada, senna), ginkgo

Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity, Cross-sensitivity with other thiazides or sulfonamides may exist. Some products contain tartrazine and should be avoided in patients with known intolerance. Anuria, lactation. Use cautiously in: Renal or severe hepatic impairment preganancy (jaundice or thrombocytopenia may be seen in the newborn) Common side effects dizziness, drowsiness, lethargy, weakness, hypotension, anorexia, cramping, hepatitis, nausea, vomiting, photsensitivity, rashes hyperglycemia, hypokalemia, dehydration, hypercalcemia, hypochloremic alkalosis, hypomagnesemia, hyponatremia, hypophosphatemia, hypovolemia, blood dyscrasias, hyperuricemia, elevated lipids, muscle cramps, pancreatitis. Lab value alterations caused by medicine

Nursing Process - Assessment (Pre-administration assessment Vital signs monitor BP, intake, output, and daily weight and assess feet, legs, and sacral area for edema daily. Excess fluid volume.

Be sure to teach the patient the following about this medication Monitor weight biweekly, change positions slowly (hypotension), use sunscreen and protective clothing to prevent photosensitivity reactions, dietary potassium requirements, weight reduction, low-sodium diet, regular exercise, smoking cessation, alcohol, stress management, monitor BP, OTC meds for cough or colds; muscle weakness, cramps, nausea, vomiting, diarrhea or dizziness Assessment Evaluation Why would you hold or not give Check after giving this med? Decrease in blood pressure Electrolyte imbalance; risk of toxicity if Increase in urine output digoxin is also be taken Decrease in edema

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