An adult with acute pulmonary edema has a prescription for furosemide 80 mg IV. Which administration plan best reduces the risk of ototoxicity?

1 Infuse at no more than 4 mg/min, taking at least 20 minutes to give the dose. ✓ Correct answer
2 Give the entire dose by rapid IV push over 30 seconds for the fastest diuresis.
3 Dilute the dose and infuse it over 5 minutes because dilution prevents hearing injury.
4 Delay the dose until pulmonary symptoms resolve because all IV furosemide is ototoxic.

Explanation

Rapid IV furosemide administration increases the risk of tinnitus and reversible or irreversible hearing impairment. A controlled infusion rate no faster than 4 mg/min means an 80 mg dose should take at least 20 minutes.

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In-depth explanation

Quick answer
Give 80 mg over at least 20 minutes.

Why this is correct
Furosemide-associated ototoxicity is more likely with rapid injection, high doses, or renal impairment. The labeled controlled-infusion ceiling is 4 mg/min; 80 divided by 4 equals 20 minutes.

Easy analogy or mental picture
The total dose is the distance and 4 mg/min is the speed limit.

Memory hook
IV furosemide: four milligrams per minute or slower.

NCLEX decision rule
For an IV medication with a labeled maximum rate, calculate the minimum administration time before giving the dose.

Why the other choices are wrong
Rapid push and a 5-minute infusion exceed the rate ceiling; delaying indicated therapy does not follow the prescription or solve the administration risk.

References

1DailyMed: Furosemide injectionOtotoxicity warning and controlled IV infusion rate

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An adult with acute pulmonary edema has a prescription for furosemide 80 mg IV. Which administration plan best reduces the risk of ototoxicity?

In-depth explanation

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