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CVS

The nurse administered intravenous bumetanide to a client being treated for heart failure. Which outcome indicates that the medication has achieved the expected effect?

Cough becomes productive of frothy pink sputumUrine output increases from 10 mL/hr to greater than 50 mL hourlyThe serum potassium level changes from 3.8 to 3.1 mEq/L (3.8 to 3.1 mmol/L)B-type natriuretic peptide (BNP) factor increases from 200 to 262 ng/mL (200 to 262 mcg/L)

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ExplanationBumetanide is a diuretic and expected outcomes include increased urine output, decreased crackles, and decreased weight. Potassium loss is a side effect rather than an expected effect of the diuretic. Frothy pink sputum indicates progression to pulmonary edema. A BNP greater than 100 pg/mL (100 ng/L) is indicative of heart failure; thus, a rise from a previous level indicates worsening of the condition.

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