Critical Thinking Exercise
Let's find the secrets in Erika's Room
What to know about Heart Failure
Secret #1
- Lasix for fluid overload
- Digoxin to strengthen the contractility of the heart. It reduces heart rate. Hold for heart rate < 60 bpm
Secret #2
It’s trying to tell you that one of the side effects of furosemide or lasix is hypokalemia. Clients may have to eat a banana a day to prevent hypokalemia. Unless, of course, if the client has renal failure or renal insufficiency, the client shoudl stay away from high potassium foods. It all depends on their potassium levels.
Secret #3
If she is getting lasix, she will make a large amount of urine and she will need a foley catheter. With heart failure, Erika may not only be on bedrest, but needs a good record of intake and output.
Secret #4
This is high fowler’s position. High fowler’s position is the best position for clients with heart failure since allows better expansion of the lungs. Positioning the client in fowler’s position is PRIORITY. DO THIS FIRST.
Secret #5
This is hard to spot, but if Erika is in heart failure and she is getting lasix, you need to watch for hypokalemia. One important symptom of hypokalemia is muscle weakness. The NCLEX loves to ask you about this side effect of lasix/furosemide
Secret #6
One important side effect of digoxin/lanoxin toxicity is visual disturbances such as seeing yellow spots. You must know this for the NCLEX.
Secret #7
I hope you did not think that it is because they are both medications. The reason is because furosemide causes hypokalemia. Hypokalemia potentiates digoxin toxicity. If a client is on both you need to monitor potassium and digoxin levels closely.