I'm a first semester ADN student....
We have to prep for our patients the night before which includes writing up their scheduled and PRN meds. My patient was in for acute kidney failure and hypokalemia. His hx includes HTN, CAD, CHF, caridiomyopathy, cardiomegaly, and gout. His MAR says he's on furosemide "60mg = 6mL" IV push (through saline lock; no IV fluids hung) daily. My instructor's written remark to that was "WOW" and later in my assessment notes where I noted he had no edema (lung sounds clear throughout), her comment was, "Wow, 60mg of lasix!" I see from the Mosby's drug book that the normal dose IM/IV is 20-40mg increased by 20 mg q 2hr until the desired response is achieved.
I'm not passing meds yet and won't be pushing IV meds until 2nd or even 3rd semester. All I know about about acute kidney failure and CHF I've learned from Ignatavicius. It seems to me that might be a "higher" dose for the norm but that is this patient's therapeutic dose. And I would expect that if this the therapeutic dose, there would be no edema. Am I on the right track?
This is the patient I was assigned to write up a care plan on. He was discharged the same day I met him so unless I go to medical records and request his chart, I have no way to interview him further. I do plan to verify the dosage on the chart. My purpose for asking if I'm on the right track is so I can focus on another nursing diagnosis for him and all that goes with it.