A nurse is assessing a client who has preeclampsia and is receiving magnesium sulfate via continuous IV infusion.

For which of the following therapeutic effects should the nurse monitor the client

The correct answer is A.

Weight loss.

Furosemide is a loop diuretic that is used to treat fluid volume excess by increasing the excretion of water and electrolytes through the kidneys. Weight loss is an indication that the medication has been effective in reducing the excess fluid in the body.

Choice B is wrong because decreased inflammation is not a direct effect of furosemide.

Inflammation is a response to tissue injury or infection, and furosemide does not have any anti-inflammatory properties.

Choice C is wrong because increased blood pressure is not an indication of furosemide effectiveness.

Furosemide lowers blood pressure by reducing the preload and afterload on the heart.

Increased blood pressure may indicate that the dose of furosemide is insufficient or that there are other factors contributing to hypertension.

Choice D is wrong because decreased pain is not an expected outcome of furosemide therapy.

Furosemide does not have any analgesic effects, and pain may be caused by various conditions that are not related to fluid volume excess.

Normal ranges for weight, blood pressure and pain vary depending on the individual patient’s baseline and goals.

However, some general guidelines are:

• Weight: A weight loss of 0.5 to 1 kg per day is considered safe and effective for patients with fluid volume excess.
• Blood pressure: The target blood pressure for most patients with heart failure is less than 130/80 mmHg.
• Pain: The pain level should be assessed using a valid and reliable scale, such as the numeric rating scale or the visual analogue scale, and treated according to the patient’s preference and tolerance.

Choice A option

Fibrinogen level: Fibrinogen is a protein involved in the blood clotting process, but in this case, it is not appropriate because is not the primary laboratory test used to monitor warfarin therapy. Monitoring fibrinogen levels is more relevant in assessing bleeding disorders or certain medical conditions.

Choice B option

PTT (Partial Thromboplastin Time): PTT is another laboratory test used to evaluate blood clotting function, particularly the intrinsic pathway of the clotting cascade. PTT is not routinely used to monitor warfarin therapy; it is more commonly used to monitor other anticoagulant medications like heparin.

Choice C option

The nurse should plan to report the client's INR (International Normalized Ratio) to obtain a prescription for the client's daily warfarin. INR is a critical laboratory test used to monitor the effectiveness and safety of warfarin therapy.

Warfarin is an anticoagulant medication commonly prescribed to prevent and treat blood clots. It works by interfering with the body's ability to use vitamin K to form blood clots. Monitoring the INR is essential because it indicates how long it takes for the blood to clot, and it helps determine if the client's warfarin dosage needs adjustment to achieve the desired level of anticoagulation.

Choice D option

Platelet count: Platelet count is essential to assess the number of platelets in the blood, which are crucial for normal clotting. However, platelet count monitoring is not the primary focus when prescribing warfarin. It is typically used to evaluate thrombocytopenia (low platelet count) or other conditions affecting platelet function.