Question

You are a home health nurse caring for a patient who has recently been diagnosed with heart failure and started on Po furosemide (Lasix) daily. The patient tells you she is not taking the medication as prescribed because she was having to get up so much at night and urinate. She is also concerned that she has been having terrible leg cramps, especially at night, since starting the diuretic. What are two key nursing interventions for this patient you are seeing today? Be complete with your answers, explaining what assessments and education you would need to include and the rationale for doing so

Answer 1

Diuretics are drugs that cause diuresis. It increases the production of urine. It is also known as “water pills”which increase the amount of water and salt excreted from the body as urine. It is mostly prescribed to treat high blood pressure and also for other conditions also.

Assess the urinary output and the amount of fluids taken by the patient. Assess for swelling or oedema. Check the electrolyte level in blood.

Patient has complaints of increased urination at night and nocturnal leg cramps. The reason for that is the action of the drug is to excrete more amount of water and salts. The patient can avoid taking diuretics during night time. She should be advised that she has to consult the physician before skipping any dose of diuretics as it will cause some serious side effects.

Leg cramps occurs because of the volume depletion as she is on diuretics. Patient can be advised to maintain adequate hydration so that she can reduce the possibility of getting leg cramps.  She can take a warm tub bath or she can take a hot shower with stream directed towards the cramp area which increases the blood circulation thereby reduces the pain.Walking and leg jiggling followed by elevation of the leg also helps by increasing the blood supply. Vitamin B complex also helps to reduce the leg cramps.