Question

Ms C. J. A patient on the medical-surgical unit, was adminitted 2 days before with a diagnoses of exacerbation of heart failure. this morning her blood pressure is 175/80 mm Hg. She denies chest pain but states that she has been experiencing shortness of breath at night while sleeping. her baseline weight at admission was 170 lb, but this morning's scale indicates a 4-lb weight gain, and +3 pitting edema to the lower extremities is evident. The nurse telephones the doctor and recieves an order for furosemide 40 mg by mouth twice daily and metopolol 25 mg PO daily to start immediately. 4. the nurse scans the medications in the electronic health record and medication administration record and administers the metoprolol. when she attempts to administers the furosemide, the patient states, " I don't want the water pill." what are the nurse next action?

Answer 1

Patient has rights to refuse the medication, but it is nurses responsibility to make them understand the health condition and the possible outcomes of the medication. Most of them avoid diuretics(water pill) for the reason of frequent urination. Ask Ms. C.J the reason for refusing the medication, Explain her in detail about her increased blood pressure, edema, due to retention of water and the water pill will improve your kidney to excrete more amount of sodium into the urine as well as reduce her edema and blood pressure. Inform her the second dose given at early evening so that the frequent urination will not disturb her sleep. Reassure the patient to take a right decision.

Still, if the patient is refusing to take medication, then inform the physician and ask for an alternative. Always the nurses should document the refusal of medication and the reason for refusal to protect them legally.