A furosemide infusion delivers an intravenous dose of a diuretic medication to encourage a patient's body to expel excess fluids. Fluid buildups around the heart and lungs can be dangerous and may occur in a variety of conditions, particularly with hospitalized patients. Doctors may recommend this medication to reduce the buildup and get the patient more stable and comfortable. Receiving a furosemide infusion may help wean someone from a ventilator in cases of congestive heart failure and certain other conditions.
This medication triggers the kidneys to eliminate more fluid in the urine, which can reduce the swelling caused by fluid buildups. It is also available in the form of oral tablets. For one time use, a doctor may ask for a bolus or “push” of furosemide to see if this stabilizes the patient. In other cases, a continuous furosemide infusion may be necessary to keep the patient's kidneys working to drain off the excess fluid. As the patient starts to recover, the doctor can lower the dose and eventually stop altogether.
Like other diuretic medications, furosemide can be dangerous and must be used with care. In patients with hypovolemia, where the blood volume is low, this medication can be contraindicated, because the patient may experience dangerously low blood pressure. Patients in a state of kidney failure can also be at risk if they take furosemide. The doctor may request a quick blood test to screen for potential contraindications before putting a patient on this drug.
Patients on a furosemide infusion are usually hospitalized because they are ill and require monitoring for their underlying health problems. Hospital protocol may require some special monitoring of patients on furosemide to check for dangerous drops in blood pressure and other complications. Nurses and other care providers may also be encouraged to double check the medication and the dosage, questioning doses that seem unusual or prescriptions in patients they feel could be put at risk by the medication. These protect patient safety, and allow nurses to respond proactively if a patient appears to be in distress.
While on a furosemide infusion, urine output can increase. Nurses may periodically check the urine to look for signs of abnormal chemistry, blood in the urine, and other symptoms of complications. As the patient recovers and the swelling drops, the doctor can discuss the possibility of reducing the dosage of the infusion. The goal is usually to get the patient stable enough to move to a step-down ward where less stringent monitoring is required, an important stage in the process of getting the patient home.
