Lasix Furosemide

NURS 1566 Clinical Form 3: Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name furosemide Peak 1-2 hrs

Trade Name Classification Dose Route Time/frequency Lasix loop diuretics 20 mg PO daily Onset Duration Normal dosage range 30-60 min 6-8 hrs 20-80 mg/day as a single dose initially, may repeat in 6-8 hr; may increase dose by 20-40 mg q 6-8 hr until desired response. Maintenance doses may be given once or twice daily or intermittently for 2-4 days/week Why is your patient getting this medication For IV meds, compatibility with IV drips and/or Fluid retention solutions N/A Mechanism of action and indications (Why med ordered) Inhibits the reabsorption of sodium and chloride from the loop of Henle and distal renal tubule. Increases renal excretion of water, sodium, chloride, magnesium, hydrogen, and calcium. May have renal and peripheral vasodilatory effects. Effectiveness persists in impaired renal function.

Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity, cross-sensitivity with thiazides and sulfonamides may occur, pre-existing electrolyte imbalance, hepatic coma, or anuria. Some liquid products may contain alcohol, avoid in patients with alcohol intolerance. Use cautiously in: severe liver disease (may precipitate hepatic coma; concurrent use with potassiumsparing diuretics may be necessary), electrolyte depletion, geriatric patients may have increased risk of side effects, especially hypotension and electrolyte imbalance, at usual doses. Diuretic use is associated with increased risk for falls in older adults. Assess falls risk and implement fall prevention strategies. Common side effects dehydration, hypochloremia, hypokalemia, hypomagnesemia, hyponatremia, hypovolemia, metabolic alkalosis

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) ↑ hypotension with antihypertensives (labetalol, avapro).

Lab value alterations caused by medicine May cause ↓ serum potassium, calcium, and magnesium concentrations. May also cause ↑ BUN, serum glucose, creatinine, and uric acid levels Be sure to teach the patient the following about this medication Instruct patient to take furosemide as directed. Take missed doses as soon as possible; do not double doses. Caution patient to change positions slowly to minimize orthostatic hypotension. Caution patient that the use of alcohol, exercise during hot weather, or standing for long periods during therapy may enhance orthostatic hypotension. Instruct patient to consult health care professional regarding a diet high in potassium. Advise patient to consult health care professional before taking OTC medication or herbal products concurrently with this therapy. Instruct patient to notify health care professional of medication regimen before treatment or surgery. Caution patient to use sunscreen and protective clothing to prevent photosensitivity reactions. Caution older patients or their caregivers about increased risk for falls. Suggest strategies for fall prevention. Advise patient to contact health care professional immediately if muscle weakness, cramps, nausea, dizziness, numbness, or tingling of extremities occurs. A d v i s e p a t i e n t t a k i n g

Nursing Process- Assessment (Pre-administration assessment) Monitor blood pressure and pulse before and during administration. Monitor frequency of prescription refills to determine compliance in patients treated for hypertension. Assess for allergy to sulfonamides. Assess fluid status during therapy. Monitor daily weight, intake and output ratios, amount and location of edema, lung sounds, skin turgor, and mucous membranes. Notify physician or other health care provider if thirst, dry mouth, lethargy, weakness, hypotension, or oliguria occurs.

Assessment Why would you hold or not give this med? Dehydration, excessive weight gain

Evaluation Check after giving

Decrease in edema. D e c r e a s e i n a b d o m i n a l g i r t h .

I n c r e a s e i n u r