Diuretic Teaching and Orthostatic Safety

Diuretics increase renal sodium and water excretion. They are used for conditions such as edema and hypertension, but their effects differ by class. Loop diuretics such as furosemide inhibit sodium reabsorption in the ascending limb of the loop of Henle. Thiazides such as hydrochlorothiazide increase sodium and chloride excretion through effects on tubular electrolyte reabsorption. Potassium-sparing diuretics such as spironolactone oppose aldosterone in the distal nephron, increasing sodium and water excretion while limiting potassium loss. Diuresis can reduce circulating volume and blood pressure. On standing, blood is redistributed toward the lower body; normal autonomic responses increase vascular tone and help preserve venous return. Volume depletion, medication effects, or impaired autonomic compensation can reduce cerebral perfusion and cause light-headedness, blurred vision, weakness, fainting, or a fall. Orthostatic dizziness is a warning pattern, not a diagnosis by itself. Safe RPN care links symptoms with position, medication timing, blood-pressure trend, fluid balance, weight trend, urine output, renal function, and electrolytes. The priorities are injury prevention, focused assessment, timely communication, and care within the prescription, authorized scope, and employer policy. The RPN does not...