After administering furosemide to a 16-month-old child who has congestive heart failure, a nurse would expect to make which of the following observations?

Question

Question

Answer 1

Correct Answer: A 10 mL/kg increase in urine output

Rationale:

Furosemide is a loop diuretic commonly used to treat conditions like congestive heart failure (CHF) by promoting the excretion of excess fluid in the body.
In a pediatric patient with CHF, the primary goal of administering furosemide is to reduce fluid overload, which is often monitored by an increase in urine output.
An increase in urine output, such as 10 mL/kg, indicates that the drug is effectively helping to remove excess fluid from the body, thereby reducing symptoms associated with fluid overload like edema and respiratory distress.

Explanation of Other Options:

A decrease in rhonchi when listening to breath sounds

Rationale: While a decrease in rhonchi (a type of lung sound associated with fluid in the airways) might be an eventual outcome of effective diuretic therapy, it is not an immediate or primary indicator of furosemide efficacy. The primary direct effect is increased urine output, not immediate changes in lung sounds.

A 20 mmHg decrease in systolic BP

Rationale: A significant decrease in blood pressure, such as 20 mmHg in systolic BP, is not a typical or desired outcome of furosemide administration in children with CHF. Such a drop could indicate hypotension, which might require medical intervention.

An increase in apical heart rate

Rationale: An increase in heart rate is not a direct or expected outcome of diuretic therapy. In fact, increased heart rate could indicate dehydration or a compensatory response to decreased cardiac output, which would be concerning in a pediatric patient with CHF.

Conclusion:

The primary and most direct indicator of the effectiveness of furosemide in a child with congestive heart failure is an increase in urine output. This demonstrates the drug’s action in reducing fluid overload. Other options are either not direct indicators or could be indicative of adverse effects.