A client diagnosed with chronic renal failure and has gained 4 pounds in the past 24 hours. The nurse anticipates that the client will receive which diuretic?
1. Triamterene (Dyrenium)
2. Ethacrynic acid (Edecrin)
3. Mannitol (Osmitrol)
4. Hydrochlorothiazide (HCTZ)
Correct Answer: 2
Rationale 1: Triamterene, a potassium-sparing diuretic, produces only a weak diuresis.
Rationale 2: As a loop diuretic, ethacrynic acid can produce significant diuresis in the presence of renal failure.
Rationale 3: As an osmotic diuretic, use of mannitol is contraindicated in renal failure.
Rationale 4: Hydrochlorothiazide is not effective in the presence of renal failure.
Global Rationale: As a loop diuretic, ethacrynic acid can produce significant diuresis in the presence of renal failure. Triamterene, a potassium-sparing diuretic, produces only a weak diuresis. As an osmotic diuretic, use of mannitol is contraindicated in renal failure. Hydrochlorothiazide is not effective in the presence of renal failure.
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