A patient is admitted with pulmonary edema and is receiving IV Furosemide (Lasix), is on strict intake and output, and is placed in Semi-Fowler's position.
Which assessment finding indicates effectiveness of interventions?

Choice A rationale

A potassium level of 5.0 mEq/L is at the high end of the normal range, which is typically 3.5 to 5.0 mEq/L. While this is a normal finding, it does not specifically indicate that the interventions for pulmonary edema and fluid overload are effective. Furosemide is a loop diuretic that usually causes potassium loss. A stable potassium level is good, but it is not the primary clinical indicator that the fluid in the lungs has been successfully cleared.

Choice B rationale

A weight gain of 1 pound (0.5 kg) indicates that the patient is retaining fluid rather than losing it. In the context of pulmonary edema and IV Furosemide therapy, the goal is diuresis and weight loss. Effective treatment should result in a decrease in weight as excess interstitial and intravascular fluid is excreted by the kidneys. A gain suggests that the heart is still struggling to pump effectively or that the diuretic dose is insufficient to manage the overload.

Choice C rationale

A heart rate of 110 BPM indicates tachycardia, which is often a compensatory mechanism for decreased cardiac output or respiratory distress in pulmonary edema. A normal adult heart rate ranges from 60 to 100 BPM. An elevated heart rate suggests that the patient's cardiovascular system is still under significant stress. Effectiveness of treatment would be better demonstrated by a heart rate returning to the normal range as oxygenation improves and the fluid volume in the vasculature decreases.

Choice D rationale

Clear lung sounds are a definitive indicator that the interventions for pulmonary edema are working. Pulmonary edema involves the accumulation of fluid in the alveoli, which produces crackles or rales upon auscultation. Furosemide works to remove this excess fluid, while the Semi-Fowler's position improves lung expansion and gas exchange. When the nurse hears clear lung sounds, it signifies that the fluid has been cleared from the alveolar spaces, directly demonstrating the success of the treatment.