Hello! The other night I had a pt with end stage renal failure, anuria, hemodialysis. He was on a vent, doing fine, and then his SaO2 dropped very fast and we had hard time to bring it back. He also had extensive cardiac history, including CHF. STAT CXR was mostly whited out. Weird, because he didn't even had any fluids going. I even stopped his sedation with KVO because we planned to extubate him in the morning. He also had dialysis that day. The doc gave a bunch of orders, including morphine (to calm him down and stop air hunger? the pt was somewhat awake by then), nitro drip (do dilate blood vessels in the lungs?) and Lasix IV push. With Lasix I was puzzled. I read that Lasix is contraindicated to pt with anuria. Besides, how would we get read of the fluids from the lungs if all the fluids are going to stay in his system anyway? He is not going to produce urine to get rid of his pulmonary edema. I asked the doc about it, but he only gave me the look as he is one of those who are too good to answer some nurse. I cannot find anything on-line and other nurses didn't know why either. My only guess is that Lasix would shift fluids from lungs into blood vessels and maybe the doc was planning to send request for a dialysis next day? Anybody has more clear understanding of it?
I appreciate any reply!