A nurse is caring for an obese patient who is 3 days postoperative. Upon assessment, the nurse discovers that the patient is short of breath, has respirations of 32/minute, and is coughing up pink, frothy sputum
The nurse should anticipate the administration of which medication?
a. Mannitol (Osmitrol)
b. Furosemide (Lasix)
c. Hydrochlorothiazide (HydroDIURIL)
d. Spironolactone (Aldactone)
ANS: B
Furosemide should be administered to this patient, because it is a rapid and highly effective diuretic, which is indicated for a patient in pulmonary edema, as described. It also can be given intravenously to increase the rapidity of its effectiveness.
Mannitol typically is indicated for patients with increased intracranial pressure caused by increases in cerebrospinal fluid. Mannitol must be stopped immediately if signs of pulmonary congestion or heart failure occur.
Hydrochlorothiazide and spironolactone are not indicated for pulmonary edema, because their diuretic effects are less rapid and effective than are needed to manage a patient with pulmonary edema.
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