Generic Drug Name: Furosemide
Brand Names: Lasix
Classification:
Therapeutic: Diuretics
Pharmacologic: Loop diuretics
Indications:
- Edema from heart failure, liver failure, or renal disease
- Hypertension
Mechanism of Action:
Inhibits reabsorption of sodium and chloride from the loop of Henle and distal renal tubule. Increases excretion of water, sodium, chloride, magnesium, potassium, and calcium from the kidneys.
Expected Response: diuresis of excess fluid and decreased blood pressure.
Common Adult Doses: (ALWAYS CHECK YOUR ORDERS)
For edema:
Oral
20-80 mg/day as initial once daily dose; maintenance dose can be given twice daily
IM or IV
20-40 mg every 6-12 hours as maintenance dose
Continuous infusion: bolus 0.1 mg/kg followed by rate of 0.1 mg/kg/hr; max dose 0.4 mg/kg/hr
For hypertension:
Oral
40 mg twice a day (when added with other meds, hypertensive med doses should be decreased)
Contraindications:
- Hypersensitivity to Furosemide
- Hepatic coma
- Anuria
- Alcohol intolerance
Side Effects:
Common
- Dehydration
- Hyponatremia
- Hypokalemia
- Hypocalcemia
- Hypochloremia
- Hypomagnesemia
- Hypovolemia
- Metabolic alkalosis
Life-Threatening
- Aplastic anemia
- Agranulocytosis
- Erythema multiforme
- Stevens-Johnson syndrome
- Toxic epidermal necrolysis
Nursing Considerations:
Assessment
- Assess fluid status – skin turgor, edema, lung sounds, and mucous membranes
- Daily weights; strict intake and output measurements
- Monitor BP and HR before administering
- Monitor skin for rash, could be sign of Steven-Johnson syndrome
- Monitor labs – electrolytes, renal and hepatic functions, blood sugar, and uric acid levels
Nursing Diagnoses
- Excess fluid volume (indications)
- Deficient fluid volume (side effects)
Implementation
- Give the last dose of the day no later than 5 pm to avoid disruption of the sleep cycle
- IV route is preferred over IM
- Give PO dose with food or milk to avoid gastric irritation
- Educate patient to
- take at the same time every day
- take with meals or soon after
- monitor their weight daily and report an increase in 3 pounds in a day to their doctor
- eat a diet high in potassium
- change positions slowly as their blood pressure may drop more easily
- notify their provider immediately if they develop – rash, muscle weakness, cramps, nausea, dizziness, numbness, or tingling of the extremities
Expected Outcomes
- Decreased edema
- Decreased abdominal girth and weight
- Increased urinary output
- Decrease in blood pressure
Reference
Vallerand, A. H. & Sanoski, C. A. (2019). Davis’s drug guide for nurses. (16th ed., pp. 602-604). F.A. Davis Company.
