A nurse is caring for a client with heart failure who is receiving furosemide (Lasix). Which of the following findings should indicate to the nurse that the medication is effective?

Furosemide (Lasix) is a diuretic that helps reduce fluid overload and edema in clients with heart failure.Increased urine output indicates that the medication is effective in removing excess fluid from the body and improving cardiac function.

Choice B is wrong because Decreased blood pressure is wrong because furosemide (Lasix) does not directly lower blood pressure, although it may have a mild effect due to reduced blood volume.Decreased blood pressure may also indicate hypovolemia, dehydration, or shock, which are complications of heart failure and diuretic therapy.

Choice C is wrong because Increased heart rate is wrong because furosemide (Lasix) does not affect the heart rate, unless the client develops electrolyte imbalances or hypovolemia, which can cause tachycardia.Increased heart rate may also indicate worsening heart failure, as the heart tries to compensate for reduced cardiac output.

Choice D is wrong because Decreased respiratory rate is wrong because furosemide (Lasix) does not affect the respiratory rate, unless the client develops respiratory depression or alkalosis, which are rare side effects of the medication.Decreased respiratory rate may also indicate fatigue, sedation, or opioid overdose, which are not related to heart failure or diuretic therapy.

Normal ranges for urine output are 30 to 60 mL/hr for adults, blood pressure is 120/80 mm Hg or lower for normal and 140/90 mm Hg or higher for hypertension, heart rate is 60 to 100 beats/min for adults, and respiratory rate is 12 to 20 breaths/min for adults.

Captopril (Capoten) is an ACE inhibitor that can cause a dry, nonproductive cough as a side effect. This cough may be bothersome and interfere with the quality of life of the client.The client should inform the provider if this occurs, as the medication may need to be changed or adjusted.

Choice A is wrong because captopril should be taken one hour before meals, not with food.Food may decrease the absorption and effectiveness of the medication.

Choice B is wrong because captopril can cause hyperkalemia, or high levels of potassium in the blood, by decreasing aldosterone secretion.The client should avoid foods high in potassium, such as bananas, oranges, potatoes, and tomatoes, and have their potassium levels monitored regularly.

Choice D is wrong because captopril can cause hypotension, or low blood pressure, especially when the client first starts taking the medication or when the dose is increased.The client should take captopril in the morning or during the day, not at bedtime, to avoid orthostatic hypotension and falls.The client should also rise slowly from a sitting or lying position and report any symptoms of dizziness, lightheadedness, or fainting to the provider.