Student Name: Elaine Edberg
Medication: furosemide
Category Class: loop diuretic
Purpose of Medication
Expected Pharmacological Action
Works in the loop of Henle of nephrons. Blocks
reabsorption of NaCl and water. Causes extensive
diuresis even with severe renal impairment
Complications
Dehydration, hyponatremia, hypochloremia,
hypotension, ototoxicity, hypokalemia
Contraindications/Precautions
Contraindications: anuria
Precautions:
- pregnant/lactating women (safety not
established)
- pts with DM, dehydration, electrolyte
depletion, gout
- pts taking digoxin, lithium, ototoxic meds,
NSAIDs, other antihypertensives
Review Module Chapter: Pharm 18
Therapeutic Use
CKD
Emergent need for rapid mobilization of fluid
Medication Administration
- Administer orally, IM, IV bolus
dose, or cont IV infusion
PO:
- 20-80mg/day
- Repeat q6-8h
- May increase dose by 20-40mg q68h until desired response
IM IV:
- 20-40mg/dose
- Repeat q6-12h
- May increase by 20mg q1-2h until
desired response
- IV: 20 mg/min or slower
Nursing Interventions
- obtain baseline data and regularly
monitor orthostatic BP, wt,
electrolytes, any edema
- weigh pts at same time ea day
- monitor BP and I&O
- avoid administering med late to
prevent nocturia; admin between
0800-1400
- if K level drops below 3.5, monitor
ECG and notify provider
Interactions
- digoxin toxicity (ventricular dysrhythmias) can
occur in presence of resultant hypokalemia
- concurrent use of antihypertensives can have
additive hypotensive effect
- lithium carbonate blood levels can increase
and lead to toxicity if resultant hyponatremia
occurs
- NSAIDs decrease blood flow to kidneys and
reduces diuretic effect
Evaluation of Medication Effectiveness
Increase in urine output
Client Education
- Get up slowly to minimize postural
hypotension and monitor BP and
for hypovolemia
- If faintness or dizziness occur, sit or
lie down immediately
- Report significant wt loss,
lightheadedness, dizziness, GI
distress, general weakness =
hypokalemia or hypovolemia
- Consume foods high in potassium
- Observe for hypocalcemia: muscle
twitching, weakness, tremors
- Report ototoxicity: tinnitus or
hearing loss