The patient with congestive heart failure in the cardiac intensive care unit (CICU) is ordered to receive IV furosemide once per day. The lab just called and reported the patient’s serum potassium is 2.9 mEq/L. The next dose of furosemide is due now. Which is the appropriate nursing action?

Hold the furosemide dose and contact the provider. Loop diuretics, like furosemide, cause three main toxicities: diuresis-related fluid and electrolyte abnormalities, ototoxicity, and hypersensitivity reactions. A potassium of 2.9 mmol/L is quite low—once levels dip below 2.5 mmol/L, lethal cardiac arrhythmias and severe muscle weakness may occur. The furosemide should be held until the electrolytes can be normalized. Salt substitute is an inefficient way to replete potassium—IV potassium is likely required for severe deficiency. An oral medication can be used for less profound hypokalemia. While hydration status should be assessed, the medication should be withheld.

The patient with congestive heart failure in the cardiac int...

NCLEX Practice
Categories
Pharmacological and Parenteral Therapies
View Question

Category: Pharmacological and Parenteral Therapies
Difficulty: 6

Topics: Cardiovascular Medication and Blood Products Communication & Documentation Elimination Fluid and Electrolytes Routes of Administration

Want help? View the answer with rationale.

Additional Pharmacological and Parenteral Therapies Questions

The nurse is caring for a patient who requires four intravenous drugs with four different pHs to be infused through an intravenous catheter that was just placed. In which order must they be administered to help prevent extravasation? Place the answers in the correct order.

Question Type: Put in Order
Difficulty: 9

A patient receiving chemotherapy has been prescribed ondansetron for nausea and vomiting. Which of the following medications, if already prescribed to the patient, would prompt the nurse to hold the ondansetron and contact the provider?

Question Type: Multiple Choice - Select One
Difficulty: 6

A patient presents to the emergency department complaining of intractable epistaxis. Upon assessment, the nurse notes petechiae and ecchymosis covering the patient’s chest and arms. The patient is otherwise well. Laboratory results are normal with exception of the patient’s platelet count, which is abnormally low (29,000/microL). The nurse anticipates an order for which medication?

Question Type: Multiple Choice - Select One
Difficulty: 7

Show Calculator

Want help? View the answer with rationale.

Rationale

Additional Pharmacological and Parenteral Therapies Questions

Nursing Careers

Nursing Degrees

NCLEX