June 3, 2023

The purpose of this video is to provide a better understanding of how the medication, “Furosemide,” functions. Additionally share the appropriate nurse-to-patient dialogue when administering this medication.

Hello welcome class i’m noemi i’m shauna i’m shannon and i’m tyler and we’re group four the following presentation aims to teach you more about the drug furosemide let’s get started drug classification furosemide more commonly known for its brand name lasix is pharmacologically classified as a loop diuretic the therapeutic classification is heart failure and

Hypertension next slide furosemide is used to reduce moderate to severe fluid retention associated with heart failure hypertension hepatic cirrhosis and chronic kidney disease next slide furosemide available forms on the top left corner we can see a picture of two lasix tablets here we have two 40 milligram tablets however this medication is also available in many

Other dosage amounts it is also available in a solution form such as in oral drops injections and iv bags next slide tablets range from 20 to 80 milligrams and may be taken by mouth in a single or multiple doses throughout the day depending on the indication for more emergent issues lasiks may be administered by iv to allow for a more rapid onset intramuscular

Injections are also used in rare occasions the daily dosage of furosemide should not exceed 600 milligrams per day older adults may require lower doses next slide ferostamide acts on the ascending limb of the nephron loop blocking sodium from being reabsorbed inhibiting sodium reabsorption leaves potassium chloride and water to attract the blocked sodium following

It along to the collecting duct and out into urine by blocking reabsorption in the ascending limb loop diuretics prevent more reabsorption from taking place making them more potent than other classes of diuretics and the most efficacious diuretic currently available for immediate relief iv furosemide’s quick 5-minute onset to 15-20 minute peak and 2 hour duration

Are ideal in contrast oral furosemide achieves a peak concentration slower with a 30 to 60 minute onset and average peak after 60 to 70 minutes with a longer six to eight hour duration nursing note furosemide absorption is slower than normal in patients with edema chronic renal disease and or decompensated heart failure next slide here we have listed the most

Minor and serious adverse side effects of furosemide use they are all significant but the most important ones to note are orthostatic hypotension and electrolyte imbalance with emphasis on potassium since these are the most common occurring with its use due to increased fluid and volume loss the patient’s blood pressure would be lower but can become too low thus

The patient may be at a higher risk of falls or syncope so you’d want to ensure that they are aware of this and just hit up slowly each time from a lying position risk of electrolyte imbalance due to excreting high levels of potassium could lead to hypokalemia and other heart related side effects such as muscle cramps and weakness palpitations and fatigue these

Symptoms would definitely warrant immediate medical attention for further evaluation next slide are some key points to remember before administering lasiks aminoglycosides should not be given due to the potential for nephrotoxicity and ototoxicity also the herbal supplements hawthorne and ginseng alters the effectiveness of this diuretic treatment a high sodium

Diet should be avoided some other drugs that include should be used with caution while receiving lasix treatments including corticosteroids aspirin digoxin and other medications listed in this section to the right contraindications include hypotension hypobulemia aneuria pregnancy and breastfeeding lastly this medication has a black box warning due to its potential

For severe fluid and electrolyte loss if given in excess now sit back relax grab your urinal and enjoy the following nursing application video hi noemi who do we have here today we have edward 52 years old presenting with bilateral edema hypertension and history of diabetes he was admitted two days ago with chest pain good morning my name is nurse shannon and

This is nurse noemi can you tell me your name and date of birth sure edward ryan march 8 1970 thank you edward do you know what you are here for yeah my legs hold up like water balloons which happens a lot this time felt different though my chest was hurting too so we called 9-1-1 the doctor said his hypertension has gotten worse what is this new medication they

Started him on because his heart was under so much strain he has been placed on a medication named for semi also called lasix this medication acts in the kidneys to relieve fluid retention and take strains off the heart to get his blood pressure down and reduce swelling in his ankles legs and body they have been giving him those meds since we got here he’s been

Getting up to pee a lot though is that normal yes it is very common the swelling is due to a buildup of fluid in his extremities the lasix is working in your body to remove excess salt and water to take strain off your heart producing more urine causing you to feel the need to pee more the most important thing to remember is to get up very slowly from bed or from

While seated trying to rush to get up too fast on this medication could leave you feeling dizzy or lightheaded and may lead to falls i have been feeling dizzy they just gave me a dose an hour ago how fast does this stuff work lasix takes 30 to 60 minutes and take it by map to kick in and last for six to eight hours since you have been feeling dizzy we can practice

Getting out of bed and going to the bathroom make sure there is nothing blocking the way to the bathroom keep it easy to access keeping a urinal at your bedside is a good option for nighttime urgency too especially while getting used to lasiks other common side effects you could have with lasix include fatigue nausea and or diarrhea check with your doctor right

Away if you are having dry mouth or increased thirst being in the ears is also a red flag to give us a call if you are having muscle cramps or weakness you should notify the doctor also a normally normal respiratory rate is 12 to 20 breaths per minute if you count less than 12 breaths over one minute seek medical attention it’s helpful to watch for the rise and

Fall of his chest if you’re having trouble seeing the breathing this medication may cause your blood pressure to drop if you have a way to monitor at home keep note of your blood pressure in a journal can help keep track of if it’s dropping too low i have a cuff at home but how low is too low 90 over 60 or lower is too low okay but how will this medication react

With my diabetes if your blood glucose is consistently elevated check in with your gp you will need to monitor your levels more than normal until you know how this drug will affect your body i organize our pills at what time should we give him his medication edward will take one pill twice daily with plenty of water taking the first dose early in the morning

Allows for evening dose to be earlier this may help prevent getting up too much in the evening as far as diet goes what should we address we recommend adapting to a low sodium low salt diet also with all the water lost from lasix you lose a lot of potassium and other electrolytes to offset this you need to hydrate well and eat foods high in potassium do you like

Banana yes i do fabulous bananas orange juice raisins dates and avocados are all great options that are high in potassium i have a brochure for you to take home that covers excellent diet tips you’ll receive it when you get discharged shortly it seems like he’s been getting lots of blood work here what are they looking at well this medication requires routine

Monitoring checking his levels is just one way of making sure the drug is working properly we are keeping an eye on his electrolytes making sure his kidneys and liver are okay another way to see if the medication is working well is to check those legs or ankles for swelling we know how to check by pressing the swollen area and see how long it takes to not show an

Indent exactly do you have a scale at home yes but it’s hidden in the basement after thanksgiving though you will need to weigh yourself every day at the same time preferably please be aware however if you gain or lose more than two pounds in one day please please report it to your doctor right away this medicine may make your skin more sensitive to sunlight use

Sunscreen wear a hat or and protective clothing when you are outdoors and remember to avoid sun lamps and tanning beds edward this medicine will not cure your high blood pressure but it does help control it you must continue to take it as directed if you expect to lower your blood pressure and keep it down you might have to take high blood pressure medicine for the

Rest of your life lifestyle changes such as maintaining optimal weight avoiding alcohol reducing cholesterol unsaturated fats eating lots of fruit and veggies not smoking and increasing physical activity will help do you have any questions before we go yeah when can i go home looks like you’ll be ready to be discharged soon i’ll check with the physician and get

Your paperwork started i’m going to leave you with this brochure to help you with all of the information we just covered it’s a lot to take in at once and can be overwhelming asking for help isn’t always easy but letting family or friends in on your health is important thanks nurse we will let the kids know what’s going on it means i’ll tell the kids how they can

Help informational brochure this is a brochure that was presented to our patient edward in the video clip let’s take a closer look of the content next slide as discussed in our video this is the informational brochure that was provided to our patient to have for reference while adjusting to his new diuretic drug therapy it provides important guidance for patients

Started on furosemide to ease with the transition it has listed items for patient teaching and as i discussed earlier some common side effects a patient would want to look out for as well as when to seek medical assistance based on these listed symptoms next slide please continue with the back of the brochure it provides several key items to know from the most

Common uses of ferosamide the different route and dosage options and the ways it can be taken to the potential interactions the patient would need to be aware between lasiks and other drugs as well as with herbals and foods lastly we have a wellness section that offers some diet recommendations things to avoid while on the medication and some non-pharmalogical

Ways to improve his condition next slide please thank you for listening to our presentation any questions

Transcribed from video
Furosemide (NSG 304) – Pharmacology 1 By Noemi Quirino