In adult CHF/pulmonary edema protocol, what diuretic dose is given?

• A. Lasix 40 mg IV
• B. Lasix 20 mg IV
• C. Lasix 80 mg IV
• D. Lasix 10 mg IV

Answer: (A)

In adults with congestive heart failure and pulmonary edema, the aim is rapid relief of congestion through diuresis. The protocol typically uses furosemide given IV as a bolus at 40 mg as the starting diuretic dose. This amount provides reliable diuresis in most patients, including those who have had prior diuretic exposure or substantial fluid overload, without jumping to overly aggressive dosing.

A smaller dose, like 20 mg IV, may be insufficient to produce meaningful diuresis in many patients with acute decompensation. A much larger dose, such as 80 mg IV, risks overshooting—causing excessive diuresis, hypotension, electrolyte disturbances, and potential kidney effects. A very small dose like 10 mg IV is generally too low to achieve the needed fluid-offloading in this setting. So the 40 mg IV dose hits a balance between effectiveness and safety for initiating diuresis in this protocol.