Sarah Gray
@02668478
Intro to Pharmacology
Case Study 4
Chapter 41
The Furosemide (Lasix) which lessen the fluid volume by escalate the amount of electrolytes and water that the kidneys are getting rid of. When there is less fluid volume the blood pressure will go down. Since her blood pressure is decreasing, the rate of her heart beat will decrease, diminish the amount of work that the heart has to do, and lowering how much fluid has built up in the lungs.
The nurse needs to know how fast Furosemide (Lasix) should be given, how it work with other intravenous liquids, and what Lasix’s concentration is.
The Foley catheter was ordered so it would accurately measure how much fluid was being released due to the Lasix (furosemide).
The nurse should look at her blood pressure, respirations, temperature, pulse, pulse ox, and pain. He or she should also look for sluggishness and unsureness which are signs of hyponatremia; hyperkinesis, uncontrollable muscle spasm, easily upset which are symptoms of hypochloremia; thromboembolism which can be indicated by pain in lower extremities, migraine, inability to breathe, change in level of consciousness, and pain in chest.
The nurse needs to let the prescriber know that all though the client’s potassium level was normal it was low in the normal range at the time the labs were drawn, Lasix can cause a drop in potassium, chloride, and sodium. He or she also needs to find out if the patient is currently on a regimen containing digoxin since that cause too much sodium in the body which can lead to the digoxin levels becoming toxic.
The most likely reason for the symptoms the client came in with is how much she has been eating her favorite foods which is high in salt.
The nurse needs to check the clients blood pressure laying down, sitting up, and standing, ascultate her lungs for normalcy and absence of rales, weight, how much fluids have been consumed and excreted, swelling, pain on movement, and difference in hearing.
The client needs to know that it is best to partake in foods low in sodium. Lasix and spironolactone may cause her to need to increase her potassium intake. She needs to take her medications regularly and monitor her levels with lab test. The prescriber also needs to be kept informed of whats going on. Because of her conditions and the medicine that she is taking she has to beware of differences in hearing and not enough calcium which can manifest in being very dehydrated, uncertainty, heartbeat not being normal, and weakness in muscles. She also needs to be cautioned that with her orthostatic blood pressure she needs to take extra care when changing positions of altitude it should be done slowly such as sitting to standing.
The client needs to be warned about taking any medications without letting her prescriber know first such as anything herbal, over the counter, or natural. Tests for potassium and digoxin levels need to be preformed regularly since Lasix can increase the chance of having toxic levels of digoxin in the body. Toxic levels of digoxin can present itself upset stomach and the inability to eat.