I am having a difficult time finding the answer for this question...
1. A nurse is admitting a client who has acute heart failure following myocardial infarction (MI) and is reviewing the provider's orders. Which of the following prescriptions by the provider requires clarification?
a. Morphine sulfate 2 mg IV bolus every 2 hr PRN pain
b. 0.9% normal saline IV at 250 mL/hr continuous
c. Laboratory testing of serum potassium upon admission
d. Bumetanide (Bumex) 1 mg IV bolus every 12 hr
Am I on the right track....
In my mind and rationale... Acute heart failure means fluid overload and pain.... So, I wouldn't question the morphine, or the Bumetanide because its a loop diuretic. I wouldnt question the labs for serum potassium either because of the loop diuretic... which leaves B... 0.9% normal saline IV at 250 mL/hr continuous
Oct 8, '13
by Esme12, ASN, BSN, RN Senior Moderator
Quote from lazz1
I still think fluid boluses can be one of many interventions that are applicable in a crashing/code situation. Have you been a code? All the ones I have been in, nurses are running NS fast to at least keep the BP up while meds are being administered. When the meds are working, then the boluses slow down, but fluids can be giving in a code situation.
As critical care nurse for 35 years and a trauma flight nurse working exclusively in critical care emergency medicine and cath lab......for 35 years......I have been in few codes.
I will use the fluids to flush the lines after meds and yes..... fluids run free during a code to facilitate the administration of the resuscitation meds in a pulseless patient to circulation during CPR...however it is not the fluid volume the patient necessarily needs to maintain the B/P for in a failing heart and over load of fluid will cause the heart to stop pumping and fail.
Last edit by Esme12 on Oct 8, '13