Furosemide is the most commonly used loop diuretic. Other loop diuretics include Bumetanide (Bumex), Torasemide (Demadex) and ethacrynic acid (Edecrin)
This drug may be administered intravenously or by mouth. IV administration is adventitious because it has an approximate onset of 5 minutes and is typically chosen in acute treatment scenarios like acute heart failure. IV administration has the highest risk for side effects.
Pulmonary edema is caused by an excess of fluid in the lungs making it difficult to breathe. Typically caused from heart failure and pneumonia.
Although not always indicated, Lasix may be indicated for hypervolemic patients with ARF. ARF is the rapid loss of kidney function which can be caused by multiple factors. The kidneys are unable to filter waste and fluid adequately, as well as regulate electrolyte balance. ARF can be fatal and may be reversible if managed early enough.
Indications for furosemide include scenarios of fluid volume overload such as Heart Failure, Hypertension, and Edema. Furosemide (Lasix) is typically given PO (by mouth) in management of chronic disease and has a slower immediate onset of action.
Monitoring for side effects of loop diuretics is an important assessment for the nurse to complete. Weakness, dizziness, muscle cramping, and/or altered level of consciousness may indicate electrolyte imbalances. The physician should be notified of any changes.
The provider should educate the client on the importance of consuming foods that are rich in potassium like bananas, prunes, nectarines, and especially apricots.
Due to increased fluid loss and fluid shift, the patient should be educated on managing orthostatic hypotension by changing positions slowly especially when changing from sitting to standing. If the patient experiences vertigo he or she should be instructed to sit down.
Daily weights serve as the best indicator for fluid status changes. They are most effective if obtained at the same time each day in the morning before breakfast. A change of more than 2 lbs in 24 hours should be reported. Keeping an accurate record of intake and output will also serve in assessing fluid balance.
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