A nurse is caring for a client who has acute heart failure and is receiving furosemide via IV bolus. The nurse should identify that which of the following findings indicates that the therapy has been effective?

Furosemide is a potent loop diuretic that inhibits sodium and chloride reabsorption in the ascending limb of the loop of Henle. By promoting the excretion of water and electrolytes, it reduces circulatory overload and alleviates pulmonary congestion associated with acute decompensated heart failure. Rationale: A. Furosemide typically causes a decrease in blood pressure rather than an increase, as it reduces total circulating blood volume. While stabilizing heart failure may eventually improve cardiac output, the immediate effect of diuretic therapy is a reduction in preload and systemic pressure. An increase in blood pressure would not be a direct indicator of successful diuresis. B. Decreased weight is the most reliable indicator of effective diuretic therapy because it reflects the loss of excess interstitial and intravascular fluid. In acute heart failure, rapid diuresis leads to the excretion of several liters of fluid, manifesting as a significant daily weight drop. The nurse monitors daily weights as a precise quantitative measure of the client's response to loop diuretics. C. Loop diuretics like furosemide typically cause the excretion of sodium, which can lead to hyponatremia rather than an increase in sodium levels. Elevated sodium would suggest dehydration or inadequate water excretion, which is contrary to the goal of heart failure management. The nurse should monitor for electrolyte depletion as a side effect of the treatment's success. D. Furosemide does not directly decrease blood glucose levels; in fact, loop diuretics can occasionally cause hyperglycemia or impaired glucose tolerance. A decrease in blood glucose is not a parameter used to evaluate the efficacy of fluid removal in heart failure. The nurse should focus on respiratory status, urine output, and weight changes to assess the medication's therapeutic impact.