Examkin

Question

Difficulty: EasyPharmacological and Parenteral Therapies

A 62-year-old62\text{-year-old} client is admitted to the telemetry unit with an exacerbation of heart failure. The client has +3 pitting edema in the bilateral lower extremities. The client's vital signs are blood pressure 148/92 mmHg148/92\text{ mmHg}, heart rate 88 bpm88\text{ bpm}, and respiratory rate 22 breaths/min22\text{ breaths/min}. The most recent basic metabolic panel reveals a serum potassium level of 4.2 mEq/L4.2\text{ mEq/L}. The healthcare provider prescribes 40 mg40\text{ mg} of intravenous (IV) furosemide. Which of the following is the most important nursing action when administering this medication?

  1. A
    Push the medication rapidly over 10 to 15 seconds to ensure an immediate onset of diuresis.
  2. B
    Hold the medication and notify the healthcare provider because the client's serum potassium level is abnormal.
  3. Administer the medication slowly over at least 2 minutes to prevent the risk of ototoxicity.Answer
  4. D
    Assess the client's apical heart rate for one full minute immediately prior to administration.

Answer

The correct action is to administer the intravenous furosemide slowly over at least 2 minutes to minimize the risk of ototoxicity.
The correct answer emphasizes administering IV furosemide slowly. Furosemide is a potent loop diuretic, and rapid intravenous push administration is a classic cause of ototoxicity (tinnitus and permanent hearing loss). To ensure safety, the standard administration rate is typically 20 mg20\text{ mg} per minute, meaning a 40 mg40\text{ mg} dose must be pushed slowly over at least 2 minutes.

Step-by-Step Solution

1
Analyze the clinical scenario and the prescribed medication.
The provider ordered an IV push dose of furosemide for a client with heart failure and a normal serum potassium level.
To identify specific safety parameters and contraindications for this drug before administration.
2
Recall the pharmacological safety principles for IV furosemide administration.
Furosemide must be administered slowly (typically 20 mg20\text{ mg} per minute) to prevent adverse effects.
Rapid administration is associated with speed shock, severe hypotension, and ototoxicity.
3
Select the option that aligns with safe administration guidelines.
Administering the medication over at least 2 minutes is the correct action.
This directly ensures patient safety and aligns with standard parenteral therapy protocols.

Key Concept

Safe administration of intravenous furosemide requires a slow push rate to prevent ototoxicity.
Rate this question

Topics

Pharmacological and Parenteral Therapies

More questions from this topic