One of the medications that are prescribed for a male client is furosemide (Lasix) 80 mg bid. To reduce his risk of falls, the nurse would teach him to take this medication?

1. A

   On arising and no later than 6 PM

2. B

   At evenly spaced intervals, such as 8 AM and 8 PM

3. C

   With at least one glass of water per pill

4. D

   With breakfast and at bedtime

Appeared in: NORCET 5 mains

Explanation

Listen in Hindi

• Furosemide is a potent loop diuretic that significantly increases urine output for about 3-6 hours after an oral dose.
• The primary nursing goal to reduce fall risk is to prevent nocturia (frequent urination at night).
• Scheduling the first dose in the morning and the second dose in the late afternoon (no later than 6 PM) ensures the diuretic effect occurs primarily during waking hours.
• This timing minimizes the need for the client to get out of bed to urinate during the night, which directly reduces the risk of falls associated with urgency, dizziness, and navigating in the dark.

Why Other Options Were Wrong

• Option B: An 8 PM dose will cause peak urination during normal sleeping hours, leading to nocturia and an increased risk of falls.
• Option C: This instruction is about the method of swallowing a pill and maintaining hydration, not about the timing of administration to prevent a specific adverse effect like falls.
• Option D: This is the most dangerous option. A bedtime dose of a diuretic directly induces nocturia, severely disrupting sleep and creating a high-risk situation for falls.

Related Visual

• Visual 1: Timeline Chart - A 24-hour clock graphic showing two furosemide doses at 8 AM and 4 PM. Shaded bars from 8 AM to 2 PM and 4 PM to 10 PM would represent the duration of diuretic action, visually demonstrating that the effect subsides before late-night hours, thus preventing nocturia.

Clinical Relevance

• Nursing practice connection: Use the key finding related to Medication Safety and Administration to guide bedside assessment, documentation, and the next nursing action.
• Patient education on medication timing is a critical nursing responsibility to ensure both therapeutic efficacy and patient safety.
• Failure to properly schedule diuretic doses is a common and preventable cause of nocturia, sleep disruption, and falls, particularly in the older adult population.
• What if? If the client worked a night shift and slept during the day (e.g., from 9 AM to 5 PM), the nurse should teach them to adjust the schedule. The client would take the doses upon waking (e.g., 5 PM) and about 6-8 hours later (e.g., 1 AM), ensuring the diuretic effect occurs during their 'waking' hours.

How to Approach the Question

• Identify the medication and its class: The question mentions furosemide (Lasix), which is a loop diuretic.
• Recall the primary action of the drug: Diuretics increase urine production.
• Analyze the specific goal stated in the question: The goal is to 'reduce his risk of falls'.
• Connect the drug's action to the clinical goal: Increased urination, especially at night (nocturia), forces a person to get out of bed, increasing fall risk. Therefore, the strategy is to prevent nocturia.
• Evaluate each option based on this strategy: Assess which timing schedule concentrates the diuretic effect during waking hours and avoids it during sleeping hours.
• Select the option that schedules the last dose early enough in the day for its effect to wear off before bedtime.

Concept Tested & Keywords

• Concept Tested: Medication Safety and Administration
• Stem keywords: furosemide, Lasix, bid, risk of falls
• Lead-in keywords: teach
• Clinical cues: The prescription is for a diuretic (furosemide) to be taken twice a day (bid).
• Clinical cues: The primary goal is fall prevention.

Question ID

QUnVvLJ_bNG0qpFIrK29XZ

Copy ID