What first actions should the nurse take and what are the rationales for these actions?

George Brown, 72 years of age, is a male patient who is admitted with the diagnosis of acute pulmonary edema secondary to acute left ventricular heart failure. The patient has a history of coronary artery disease that has been treated medically. The patient is anxious, pale, cold, clammy, and dyspneic. The vital signs are: blood pressure 88/50 mm Hg, heart rate 110 bpm, respiratory rate 32 breaths/min, and temperature 97°F. There are bubbling crackles and wheezing throughout the lung fields and the patient is raising frothy blood-tinged clear sputum. The patient’s admission weight is 100 kg.

a.What first actions should the nurse take and what are the rationales for these actions?

The physician ordered furosemide (Lasix) 40 mg IVP STAT.

b.What are the actions of furosemide that will help the patient?

c.What nursing actions should be implemented when administering a diuretic?