Nursing Process Focus:

Patients Receiving Furosemide (Lasix)

Assessment Potential Nursing Diagnoses

Prior to administration: Excess Fluid Volume, related to impaired
Assess for sites and amount of edema, cardiac function and output
blood pressure, pulse, and weight gain/loss Impaired Urinary Elimination, related to
(initially and throughout therapy.) diuretic therapy
Obtain complete health history including Deficient Knowledge, related to drug
allergies, heart failure, especially kidney action and side effects
and liver disease, diabetes, gout,
pancreatitis, ascites, including blood
studies: electrolytes, BUN, creatinine, uric
acid, liver function tests.
Planning: Patient Goals and Expected Outcomes
The patient will:
Demonstrate a decrease in weight.
Exhibit a decrease in peripheral edema.
Exhibit expected outcomes of diuretic therapy and list reportable side effects.
Implementation
Interventions and (Rationales) Patient Education/Discharge Planning
*Observe for side effects such as muscle *Instruct the patient to report these side effects
cramps, weakness, dizziness, confusion, immediately to the health care provider.
nausea, vomiting, diarrhea, headache,
restlessness, constipation.
*Contraindicated with history of *Instruct patient to give history of any drug
hypersensitivity to drug or sulfonamides. allergies or reactions to health care provider.
*Use with caution for severe liver disease with Instruct patient:
cirrhosis or ascites. (Increases risk of drug of signs and symptoms of liver disease
toxicity.) to immediately report symptoms to health
care provider.
*Provide information related to appropriate *Instruct patient to schedule dose in morning,
administration time (to avoid nocturia.) and not after 6pm if two times a day dose is
ordered.
*Monitor blood count, serum electrolytes, *Instruct patient to report for laboratory tests
BUN, blood sugar and uric acid when therapy as scheduled to ensure safe treatment plan.
initiated and periodically during therapy.
Evaluation of Outcome Criteria
Evaluate the effectiveness of drug therapy by confirming that patient goals and expected
outcomes have been met (see Planning).
 Nursing Process Focus:
Patients Receiving Milrinone (Primacor)

Assessment Potential Nursing Diagnoses

Prior to administration: Decreased Cardiac Output, related to
Assess for supraventricular and ventricular severe congestive heart failure
dyrhythmias, hypotension, and fluid Impaired Gas Exchange, related to heart
electrolyte balance (initially and throughout failure
therapy.) Deficient Knowledge, related to drug
Obtain complete health history including action and side effects
allergies, especially cardiac, renal disease
including blood studies: CBC, WBC with
differential to monitor for infection,
electrolytes, BUN, creatinine.
Obtain patients drug history to determine
possible drug interactions and allergies.
Assess for recent diuretic therapy.
Planning: Patient Goals and Expected Outcomes
The patient will:
Exhibit normal sinus rhythm without dysrhythmias during drug therapy.
Demonstrate a decrease in symptoms of disease process to which prior therapy was
resistant.
Demonstrate the expected outcomes of drug therapy and list reportable side effects.
Implementation
Interventions and (Rationales) Patient Education/Discharge Planning
*Observe for side effects such as headache, *Instruct the patient to report all side effects,
increased heart rate, nausea, vomiting, immediately to the health care provider.
shortness of breath, pounding headache,
faintness, dizziness, leg cramps.
*Monitor cardiac status during and following *Instruct patient to report angina immediately.
administration.
*Monitor blood pressure. (Drug may cause
hypotension.)
*Monitor fluid and electrolyte balance. Instruct patient:
(Hypokalemia must be treated before drug of signs and symptoms of hypokalemia.
administration.) to report signs and symptoms to the health
care provider.
*Monitor electrolytes and renal function. *Instruct patient to report changes in urinary
(Previous intense diuretic therapy increases output to the health care provider.
risk of hypotension. Dosage reduced for patient
with renal impairment.)
*Encourage adherence to treatment regimen. Instruct patient to:
continue low-sodium diet and daily
exercise program as prescribed.
carefully follow prescribed plan of care for
 maximum therapeutic effects.
*Monitor platelet count. *Instruct patient to report signs of unusual
bleeding, bruising.
Evaluation of Outcome Criteria
Evaluate the effectiveness of drug therapy by confirming that patient goals and expected
outcomes have been met (see Planning).