A charge nurse on a medical-surgical unit is assisting with the emergency response plan following an external disaster in the community.

In anticipation of multiple client admissions, which of the following current clients should the nurse recommend for early discharge?

The correct answer is A.

Weight loss.

Furosemide is a loop diuretic that is used to treat fluid volume excess by increasing the excretion of water and electrolytes through the kidneys. Weight loss is an indication that the medication has been effective in reducing the excess fluid in the body.

Choice B is wrong because decreased inflammation is not a direct effect of furosemide.

Inflammation is a response to tissue injury or infection, and furosemide does not have any anti-inflammatory properties.

Choice C is wrong because increased blood pressure is not an indication of furosemide effectiveness.

Furosemide lowers blood pressure by reducing the preload and afterload on the heart.

Increased blood pressure may indicate that the dose of furosemide is insufficient or that there are other factors contributing to hypertension.

Choice D is wrong because decreased pain is not an expected outcome of furosemide therapy.

Furosemide does not have any analgesic effects, and pain may be caused by various conditions that are not related to fluid volume excess.

Normal ranges for weight, blood pressure and pain vary depending on the individual patient’s baseline and goals.

However, some general guidelines are:

• Weight: A weight loss of 0.5 to 1 kg per day is considered safe and effective for patients with fluid volume excess.
• Blood pressure: The target blood pressure for most patients with heart failure is less than 130/80 mmHg.
• Pain: The pain level should be assessed using a valid and reliable scale, such as the numeric rating scale or the visual analogue scale, and treated according to the patient’s preference and tolerance.

A: Review the need for the indwelling urinary catheter daily.
This is correct because indwelling catheters should be removed as soon as possible to reduce the risk of urinary tract infection (UTI).

B: Place the drainage bag on the bed when transporting the client.
This is incorrect because the drainage bag should be kept below the level of the bladder and should not touch the floor to prevent the backflow of urine and contamination of the catheter.

C: Use soap and water to provide perineal care.
This is correct because soap and water can help to remove bacteria and debris from the meatus and prevent infection.

D: Encourage the client to drink 3000 mL of fluid daily.
This is incorrect because the client has a fluid restriction of 1000 mL daily due to heart failure. Excessive fluid intake can worsen the client’s condition and increase the workload of the heart.

E: Change the indwelling urinary catheter tubing every 3 days.
This is incorrect because changing the catheter tubing can increase the risk of infection by breaking the closed drainage system. The catheter tubing should only be changed when it is visibly soiled or malfunctioning.

F: Empty the drainage bag when it is half full.
This is incorrect because the drainage bag should be emptied at least every 8 hours or when it is one-third full to prevent back pressure and infection.