Gulf Coast Community College- Associate degree Nursing
NUR 1260C – Gerontological Nursing
Medication Cards
Student Name: _ ___________
Name of Drug: Generic: Hydrochlorothiazide
Trade: Hydrochlorothiazide and Hydralazine
Classification: antihypertensives, diuretics, thiazide diuretics
Usual Dose: 12.5-100 mg/day in 1-2 divided doses (up to 200 mg/day); not to exceed 50
mg/day for hypertension; daily doses above 25 mg are associated with greater likelihood
of electrolyte abnormalities.
Resident/Client/ Patient Dose:
Action: Increases excretion of sodium and water by inhibiting sodium reabsorption in
the distal tubule. Promotes excretion of chloride, potassium, magnesium, and
bicarbonate. May produce arteriolar dilation. Lowering of blood pressure in
hypertensive patients and diuresis with mobilization of edema.
Side Effects & Toxic Effects: dizziness, drowsiness, lethargy, weakness, hypotension,
anorexia, cramping, hepatitis, nausea, pancreatitis, vomiting, photosensitivity, rashes,
hyperglycemia, hypokalemia, dehydration, hypercalcemia, hypochloremic alkalosis,
hypomagnesemia, hyponatremia, hypophosphatemia, Hypovolemia, thrombocytopenia
hypercholesterolemia, hyperuricemia, muscle cramps.
Drug Interactions: Additive hypotension with other antihypertensives, acute ingestion
of alcohol, or nitrates. Additive hypokalemia with corticosteroids, amphotericin B,
piperacillin, or ticarcillin. decrease excretion of lithium. Cholestyramine or colestipol
decrease absorption. Hypokalemia increase risk of digoxin toxicity. NSAIDs may
decrease effectiveness.
Nursing Implications: Monitor blood pressure, intake, output, and daily weight and
assess feet, legs, and sacral area for edema daily. Assess patient, especially if taking
digoxin, for anorexia, nausea, vomiting, muscle cramps, paresthesia, and confusion.
Notify health care professional if these signs of electrolyte imbalance occur. Patients
taking digoxin are at risk of digoxin toxicity because of the potassium-depleting effect of
the diuretic. If hypokalemia occurs, consideration may be given to potassium
supplements or decreasing dose of diuretic. Assess patient for allergy to sulfonamides.
Monitor blood pressure before and periodically during therapy. Monitor frequency of
prescription refills to determine compliance.
Laboratory Considerations: Monitor electrolytes (especially potassium), blood
glucose, BUN, serum creatinine, and uric acid levels before and periodically throughout
therapy. May cause increase in serum and urine glucose in diabetic patients. May cause
increase in serum bilirubin, calcium, creatinine, and uric acid, and decrease in serum
magnesium, potassium, sodium, and urinary calcium concentrations. May cause
increased serum cholesterol, low-density lipoprotein, and triglyceride concentrations.