MEDICATIONS (a)
Student: Erin Nowlin
Drug
Generic:
furosemide
Brand:
Lasix
Onset:
20-60 min
Peak:
1-2 hr
Duration:
6-8 hr
Client Information:
MF 89 yr old white
female
Dosage, Route,
& Frequency
Client:
40 mg by mouth
at bedtime for
edema
Usual:
20-80 mg by
mouth daily in
the morning. If
response is
inadequate, give
a second dose,
and each
succeeding dose,
every 6-8 hours.
Carefully
increase dose in
20-40mg
increments up to
600mg daily.
Once effective
dose is attained,
may give once or
Classification
Allergies:
NKDA
Purpose of the Drug
Pharmacologic
Classification:
Loop diuretic
Specific to this Client:
Reduce/prevent edema
Therapeutic
Action:
Inhibits sodium
and chloride
reabsorption at the
proximal and
distal tubules and
the ascending
Loop of Henle
Usual:
Acute pulmonary edema, edema,
hypertension
Date:
December 1,
2010
Nursing Implications
Side Effects/Adverse Reactions:
CNS: vertigo, headache,
dizziness, paresthesia, weakness,
restlessness, fever.
CV: orthostatic hypotension,
thrombophlebitis with IV
administration.
EENT: transient deafness,
blurred or yellowed vision,
tinnitus.
GI: abdominal discomfort and
pain, diarrhea, anorexia, nausea,
vomiting, constipation,
pancreatitis.
GU: azotemia, nocturia, polyuria,
frequent urination, oliguria.
Hematologic: agranulocytosis,
aplastic anemia, leukopenia,
thrombocytopenia, anemia.
Metabolic: volume depletion and
dehydration, asymptomatic
hyperuricemia, impaired glucose
tolerance, hypokalemia,
hypochoremic alkalosis,
Drug
Dosage, Route,
& Frequency
twice daily.
Classification
Purpose of the Drug
Nursing Implications
hyperglycemia, dilutional
hyponatremia, hypocalcemia,
hypomagnesemia.
Musculoskeletal: muscle spasm.
Skin: dermatitis, purpura,
photosensitivity reactions,
transient pain at IM injection site.
Other: gout.
Interactions:
Drug-drug. Aminoglycoside
antibiotics, cisplatin: may
increase ototoxicity. Use together
cautiously.
Drug-herb. Aloe: May increase
drug effect. Discourage use
together.
Drug-lifestyle. Sun exposure:
may increase risk for
photosensitivity reactions. Advise
patient to avoid excessive
sunlight exposure.
Effects on Labs:
-May increase cholesterol,
glucose, BUN, creatinine, and
uric acid levels. May decrease
calcium, hemoglobin,
magnesium, potassium, and
sodium levels.
Drug
Dosage, Route,
& Frequency
Classification
Purpose of the Drug
Nursing Implications
-May decrease granulocyte,
platelet, and WBC counts.
Nursing Considerations:
-Monitor weight, blood pressure,
and pulse rate routinely with
long-term use.
-Drug is potent diuretic and can
cause severe diuresis with water
and electrolyte depletion.
Monitor patient closely.
-If oliguria or azotemia develops
or increases, drug may need to be
stopped.
-Monitor fluid intake and output
and electrolyte, BUN, and carbon
dioxide levels frequently.
-Watch for signs of hypokalemia,
such as muscle weakness and
cramps.
-Consult prescriber and dietitian
about a high-potassium diet or
potassium supplements. Foods
rich in potassium include citrus
fruits, tomatoes, bananas, dates,
and apricots.
-Monitor blood glucose level in
diabetic patients.
-Drug may not be well absorbed
orally in patient with severe heart
Drug
Dosage, Route,
& Frequency
Classification
Purpose of the Drug
Nursing Implications
failure. Drug may need to be
given IV even if patient is taking
other oral drugs.
-Monitor uric acid level,
especially in patients with a
history of gout.
-Monitor elderly patients, who
are especially susceptible to
excessive diureses, because
circulatory collapse and
thromboembolic complications
are possible.
-Don’t confuse furosemide with
torsemide or Lasix with Lonox,
Lidex, or Luvox.
Client Teaching:
-Advise patient to take drug with
food to prevent GI upset, and to
take drug in morning to prevent
need to urinate at night. If patient
needs second dose, tell him to
take it in early afternoon, 6-8
hours after morning dose.
-Inform patient of possible need
to potassium of magnesium
supplements.
-Instruct patient to stand slowly
to prevent dizziness and to limit
alcohol intake and strenuous
Drug
Dosage, Route,
& Frequency
Classification
Purpose of the Drug
Nursing Implications
exercise in hot weather to avoid
worsening dizziness upon
standing up quickly.
-Advise patient to immediately
report ringing in ears, severe
abdominal pain, or sore throat
and fever; these symptoms may
indicate toxicity.
-Discourage patient from storing
different types of drugs in the
same container, increasing the
risk of drug errors. The most
popular strengths of this drug and
digoxin are white tablets equal in
size.
-Tell patient to check with
prescriber or pharmacist before
taking OTC drugs.
-Teach patient to avoid direct
sunlight and to use protective
clothing and a sunblock because
of risk of photosensitivity
reactions.
Antidote:
none
References: Kluwer, W. (2011) Nursing 2011 drug handbook (31st ed.). Ambler, Pennsylvania: Lippincott Williams &
Wilkins