RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015
Nursing Foundation
Easy
Hypertensive patient is given diuretics because it lowers blood pressure by?
Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015
Explanation
- Diuretics primarily lower blood pressure by increasing the excretion of sodium (natriuresis) from the body.
- Water follows sodium osmotically, leading to increased urine output (diuresis) and a reduction in blood volume and cardiac output.
- This initial reduction in blood volume directly lowers blood pressure.
- Over the long term, the depletion of body sodium stores also helps to decrease the stiffness of blood vessels, reducing total peripheral resistance.
Why Other Options Were Wrong
- Option A: This option is incorrect because it omits sodium, which is the primary electrolyte targeted by diuretics to induce water loss. While potassium is lost with some diuretics, it's a side effect.
- Option B: This option incorrectly includes potassium loss as part of the intended therapeutic mechanism. The goal is sodium and water excretion; potassium loss is an adverse effect that needs to be managed.
- Option D: This option is incorrect because it omits the crucial role of water. The reduction in blood volume from water excretion is a key component of how diuretics lower blood pressure.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Mechanism of action of diuretics in hypertension to guide bedside assessment, documentation, and the next nursing action.
- Nurses must diligently monitor serum electrolyte levels, especially potassium, in patients taking diuretics. Both hypokalemia (with thiazide/loop diuretics) and hyperkalemia (with potassium-sparing diuretics) are significant risks that can lead to cardiac arrhythmias.
- Patient education is a key nursing responsibility. This includes teaching patients the signs of electrolyte imbalance (e.g., muscle weakness, cramps, palpitations), the importance of adhering to dietary sodium restrictions, and to report any adverse effects.
- What if? If the patient were prescribed a potassium-sparing diuretic like spironolactone, the primary mechanism would still be sodium and water excretion, but the nurse's concern would shift from hypokalemia to monitoring for hyperkalemia (high potassium).
How to Approach the Question
- First, identify the core pharmacological concept being tested: the mechanism of action for diuretics in treating hypertension.
- Recall the fundamental principle of renal physiology and fluid balance: 'water follows salt (sodium)'.
- Evaluate the options based on this principle. The primary goal of using diuretics for hypertension is to reduce the body's fluid volume.
- Consider the role of each electrolyte mentioned. Sodium is the primary driver of water retention in the body.
- Differentiate between a drug's therapeutic effect and its side effects. Recognize that potassium loss is a well-known side effect of many diuretics, not the intended action for blood pressure control.
- Select the option that correctly identifies sodium and water as the key components of the therapeutic mechanism.
Concept Tested & Keywords
- Concept Tested: Mechanism of action of diuretics in hypertension
- Stem keywords: hypertensive patient, diuretics, lowers blood pressure
- Lead-in keywords: because
Question ID
QgzsBCyfidYwwlPHbjZxP4
Reference Book
E6 Pharmacology Katzung 16e p. 271-273
E6 Medicine Harrison 22e Part 2 p. 37-39
Practise the full RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015
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