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...

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Pharmacological and Parenteral Therapies
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Category: Pharmacological and Parenteral Therapies
Difficulty: 6

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

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