Drug Data Generic name: furosemide
Brand name: Lasix
Classification Pharmacologic class: Sulfonamide loop diuretic
Therapeutic class: Diuretic, antihypertensive
Mechanism of Action Enhances excretion of sodium, chloride, potassium by
direct action at ascending limb of loop of Henle.
Indication Treatment of edema associated with HF and
renal/hepatic disease; acute pulmonary edema.
Route IV
Dosage and frequency 20mg PRN for increase blood pressure
Contraindication Hypersensitivity to drug or other sulfonamides. Anuria.
Side effects and Adverse effects CNS: dizziness, headache, vertigo, weakness, lethargy,
paresthesia, drowsiness, restlessness, light-headedness
CV: hypotension, orthostatic hypotension, tachycardia,
volume depletion, necrotizing angiitis,
thrombophlebitis, arrhythmias
EENT: blurred vision, xanthopsia, hearing loss, tinnitus
GI: nausea, vomiting, diarrhea, constipation, dyspepsia,
oral and gastric irritation, cramping, anorexia, dry
mouth, acute pancreatitis
GU: excessive and frequent urination, nocturia,
glycosuria, bladder spasm, oliguria, interstitial nephritis
Hematologic: anemia, purpura, leukopenia,
thrombocytopenia, hemolytic anemia
Hepatic: jaundice
Metabolic: hyperglycemia, hyperuricemia,
dehydration, hypokalemia, hypomagnesemia,
hypocalcemia, hypochloremic alkalosis
Musculoskeletal: muscle pain, muscle cramps
Skin: photosensitivity, rash, diaphoresis, urticaria,
pruritus, exfoliative dermatitis, erythema multiforme
Other: fever, transient pain at I.M.injection site
Nursing Consideration 1. Check vital signs, esp. B/P, pulse, for
hypotension before administration.
2. Assess baseline renal function, serum
electrolytes, esp. serum sodium, potassium.
3. Obtain baseline weight and initiate I&O
monitoring.
4. Assess skin turgor, mucous membranes for
hydration status; observe for edema.
5. Watch for symptoms of electrolyte imbalance:
Hypokalemia may result in changes in muscle
strength, tremor, muscle cramps, altered mental
status, cardiac arrhythmias; hyponatremia may
result in confusion, thirst, cold/clammy skin.
6. Instruct patient to report signs and symptoms of
ototoxicity (hearing loss, ringing in ears,
vertigo) and other drug toxicities.
7. Encourage the patient to eat foods high in
potassium such as whole grains (cereals),
legumes, meat, bananas, apricots, orange juice,
potatoes (white, sweet), raisins.
8. Instruct patient to move slowly when rising, to
avoid dizziness from sudden blood pressure
decrease.
9. Avoid sunlight, sunlamps.
10. Report palpitations, signs of electrolyte
imbalances (noted previously), hearing
abnormalities (sense of fullness in ears,
tinnitus).
ADMISSION ENTRY
General Survey: Admitting this 61-year-old female with a decreased level of consciousness,
weak, wheelchaired, and assisted by her son, daughter, and husband with chief complaint of
shortness of breath x 2 days and productive cough.
Focus: Ineffective breathing pattern.
Data:
● Shortness of Breath x2 days
● Respiratory Rate: 24 cpm
● Productive Cough
● Use of accessory muscles
● Nasal flaring
● Snoring
Action:
● Monitored and recorded
● Positioned the patient in a high fowler’s position.
● Encouraged patient to do deep breathing exercises.
● Started PNSS 1L @100cc/hr at the left metacarpal vein.
● Inserted heplock at the right metacarpal vein for other medications.
● Administered O2 inhalation @4L/min via nasal cannula.
● Administered mannitol and ceftazidime as prescribed by the physician.
● NPO, SAP
Response:
● Lessened used of accessory muscles.
● Patient wheeled to the Intensive Care Unit.
● Endorsed to the nurse on duty.
Name of IVF Color Concentration Indication
PNSS / 0.9 NaCl Dark Green Isotonic Medications, Dehydration, Hypernatremia
D5NR Light Green Hypertonic Electrolyte Replacement, Intravascular Repletion,
caloric Support,
PLR Dark Blue Isotonic Burn, Acute Blood Loss, Electrolyte
Replacement, Fluid Resuscitation, Trauma
D5 0.3 NaCl Light Blue Hypotonic Hypernatremia, Caloric Support
D5LR Pink Hypotonic Obgyne, Lactate Replacement
D5IMB Purple Isotonic Electrolyte Replacement, Mild Dehydration, Pre
and Post operative Replacement
D5NSS Yellow Hypertonic Hyponatremia, Fluid Replacement,
Hyperkalemia, Nutritional Support
D5NM Orange Hypertonic Hyponatremia, Hypokalemia, Nutritional
Support, and Fluid and Electrolyte Replacement
D5W Red Isotonic Cardiovascular patient, hypoglycemia
1st Drawer of the Crash Cart 4th Drawer of the Crash Cart
- The first tray is for heart-related equipment, Also known as the medication drawer, the fourth
like ECG gel and electrodes. cabinet contains high-alert or emergency medications
like the ones below.
- These are essential paraphernalia of the ● 0% Dextrose 50ml-1
ECG, which measures the heart's electrical ● Adenosine 3 mg/ml
activity and monitors heart conditions. It can ● Adrenaline 1mg/ml-1
also help check if a pacemaker is working ● Amiodarone 150 mg vial
properly. ● Aspirin 81 mg tabs
● Atropine 8 mg/20 ml vial
2nd Drawer of the Crash Cart ● Benadryl 50mg
The second drawer is for intubation or airway ● Dextrose 50% and 25% in pediatric wards
supplies. Often, it contains: ● Diazepam 50 mg/10 ml
● Endotracheal tubes ● Dobutamine 250mg in 5ml or 20ml-2
● Syringes to inflate the cuff on the ● Dopamine 40 mg/ ml
endotracheal tube ● Epinephrine: EpiPen, Epinephrine 1:1,000
● Nasopharyngeal and oropharyngeal airways ● Lidocaine 100 mg
● Laryngoscope handle and blades ● Lopressor 10 mg
● Nasal filter lines ● Midazolam 50 mg/10 ml vial
● Magill forceps ● Naloxone, Narcan 1 mg/ml
● Tongue depressor ● Vasopressin 20u/ml
● Laryngeal masks ●
● Bite block 5th Drawer of the Crash Cart
● Flashlight The fifth cabinet in an emergency trolley keeps all IV
● Batteries fluids, including:
● Stylets ● 1,000 ml dextrose 5% in water solution,
● Dyna plaster D5W
● 1,000 ml normal saline solution, NS
3rd Drawer of the Crash Cart ● 1,000 ml lactate solution, Lactate’s Ringer
The third cabinet is for intravenous or IV materials, or LR
including but not limited to the following: ● 500 ml of D5W and NS
● IV start kit ● 100 ml of NS-2
● IV solutions This cart checklist outlines supplies and equipment
● 3-way stopcocks suitable for any medical facility:
● IV sets with extensions ● Defibrillators
● Catheters ● Suction devices and bag valve masks
● Vacutainers ● Drugs for peripheral and central venous
● Disposable syringes and needles access
● Disinfectants ● Calcium chloride 1g/10 ml
● Tourniquet tubing ● Sodium chloride 0.9%: 10 ml injection vial,
● Pressure monitoring line 20 ml vial
● Burette set ● Sterile water
● PosiFlush ● At least one sedative
● Disposable kidney tray ● Intubation kits
● Anesthesia
