A patient has just begun to take a prescribed diuretic. Why would the nurse tell the patient to drink 8 to 10 glasses of water daily (unless it is counterindicated)?
A) To decrease the action of the renin–angiotensin cycle
B) To make more concentrated plasma
C) To dilute the urine
D) To avoid rebound edema
D
Feedback:
Care must be taken when using diuretics to avoid fluid rebound, which is associated with fluid loss. If a patient stops taking in water and takes the diuretic, the result will be a concentrated plasma of smaller volume. The decreased volume is sensed by the nephrons, which activate the renin-angiotensin cycle. When concentrated blood is sensed by the osmotic center in the brain, antidiuretic hormone (ADH) is released to retain water and dilute the blood. The result can be "rebound" edema as fluid is retained. Drinking 8 to 10 glasses of water will not decrease the action of the renin-angiotensin cycle, or make plasma more concentrated. It may produce urine that is dilute but that is not the reason it is recommended.
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