Question

The client is admitted with a BP of 210/120. Her doctor orders furosemide (Lasix) 40mg IV stat. How should the nurse administer the prescribed furosemide to this client? A. By giving it over 1-2 minutes B. By hanging it IV piggyback C. With normal saline only D. By administering it through a venous access device

Short answer

Answer: In this situation, the most appropriate method to administer furosemide (Lasix) 40mg IV stat is to give it over 1-2 minutes. This ensures rapid action of the medication, helping to quickly lower the client's high blood pressure.

Step-by-step solution

Understand the situation

The client has a high blood pressure of 210/120 and has been prescribed furosemide (Lasix) 40mg IV (intravenous) stat. It is important for the nurse to administer the medication safely and effectively. The available options are: A) Giving it over 1-2 minutes, B) Hanging it IV piggyback, C) With normal saline only, or D) Administering it through a venous access device.

Know the medication - Furosemide (Lasix)

Furosemide is a loop diuretic that helps remove excess fluid from the body by increasing the production of urine. It is commonly used to treat high blood pressure and other conditions, such as congestive heart failure and edema. It is important to administer the medication rapidly when it is prescribed as an IV for high blood pressure, in order to quickly reduce the pressure.

Evaluate the options for administration

Let's go through the options one by one: A) Giving it over 1-2 minutes: This method involves rapidly administering the furosemide into the IV line. It is the most appropriate option for this situation, as it allows the medication to act quickly, helping to lower the client's high blood pressure. B) Hanging it IV piggyback: This method consists of attaching a secondary IV bag containing the furosemide to the client's existing IV line. It is not the best option for this situation because it generally takes much longer than 1-2 minutes to administer the medication. C) With normal saline only: This option refers to diluting the furosemide in a normal saline solution before administering it. However, it does not specify the method or rate of administration, and thus does not present a complete solution. D) Administering it through a venous access device: A venous access device (such as a central line or PICC line) allows for direct access to the client's bloodstream. While it can be used to administer furosemide, it is not the only method available, and it does not provide information about the rate of administration.

Select the appropriate method for administration

Based on the analysis, option A, giving the furosemide over 1-2 minutes, is the most appropriate method to administer the prescribed furosemide in this situation. This ensures rapid action of the medication, helping to quickly lower the client's high blood pressure.

Key concepts

Furosemide Administration

Furosemide, often known by its brand name "Lasix," is a powerful loop diuretic used extensively in the medical field to assist in the elimination of excess fluids. This diuretic promotes increased urine production, helping to decrease both volume overload and high blood pressure. Correct administration is crucial for ensuring the desired therapeutic effect and avoiding potential side effects. When furosemide is prescribed intravenously (IV), especially in urgent scenarios like acute hypertension (high blood pressure), the administration should be rapid but controlled. Administering furosemide over 1-2 minutes allows for a swift onset of action, making it easier to manage severe cases like the one described with a BP reading of 210/120. Here's the proper procedure for IV furosemide administration:

• Check the patient's identity and confirm the doctor's order for dosage and method.
• Ensure the medication is not expired and inspect the IV site for any signs of infection or inflammation.
• Use a syringe to administer furosemide directly into the IV line over the specified time (1-2 minutes).
• Observe the patient for any immediate adverse reactions like dizziness or dehydration.

Effective communication and continuous monitoring post-administration are key in mitigating any risks associated with administering furosemide.

Blood Pressure Management

Managing blood pressure is a critical component of treating patients with hypertension. Blood pressure management involves both lifestyle adjustments and pharmacological interventions, which are necessary to reduce the risk of cardiovascular complications. In acute cases, like the client with a blood pressure of 210/120, rapid pharmacological intervention is necessary. Administering IV medications such as furosemide can quickly decrease blood pressure. This method is particularly effective because it circumvents the gastrointestinal system and facilitates quick absorption into the bloodstream. Here are some key considerations for effective blood pressure management:

• Regular monitoring of blood pressure to assess the effectiveness of the intervention.
• Educating the patient about the importance of adhering to their medication schedule.
• Encouraging lifestyle modifications, such as reducing sodium intake and performing regular physical activity, to sustain long-term control of blood pressure.

Effective management balances immediate treatment needs with long-term health strategies.

IV Medication Procedures

Intravenous (IV) medication administration requires precision and adherence to proper procedures to ensure patient safety and medication efficacy. Due to its direct delivery into the bloodstream, IV administration provides rapid therapeutic effects, which is crucial in emergency situations. Here's a step-by-step guide to safe IV medication administration:

• Verify the correct medication and dosage against the physician’s order.
• Perform hand hygiene and use aseptic techniques to maintain a sterile procedure.
• Explain the procedure to the patient and obtain consent to ease their anxiety and ensure cooperation.
• Access the IV site, ensuring proper function and patency of the IV line by flushing it with normal saline if needed.
• Administer the medication at the prescribed rate, monitoring for any signs of adverse reactions or complications.

Proper IV medication procedures help avoid complications such as infiltration or phlebitis, while ensuring that medications like furosemide act quickly and effectively.