NURS 1566 Clinical Form 3: Clinical Medications Worksheets

(You will need to make additional copies of these forms)

Generic Name Trade Name Classification Dose Route Time/frequency

furosemide Lasix loop diuretics 20 mg PO daily
Peak Onset Duration Normal dosage range
1-2 hrs 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 Nursing Implications (what to focus on)

(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.
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 potassium-
sparing 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.
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Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this Check after giving
Monitor blood pressure and pulse before med?
and during administration. Monitor Dehydration, excessive weight gain
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.
Decrease in edema.

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