[Em1995]

I agree with Leslie on this. But, have some comments. Lopressor will DECREASE blood pressure, if this patient is actively dying, why continue it? I question a medical director who would approve of the patient going home with IV Lopressor.
And, the unsafe part....well, to me anyway, is the snowstorm! Given that I live in Massachusetts, I can confirm that it IS a safety issue when driving in these recent snowstorms! Just a week ago, someone passed me, going WAY too fast in a snowstorm, and lost control and crashed into a telephone pole in front of me....the person was fine, but the car was totalled.

[earle58]

Originally Posted by Em1995

I agree with Leslie on this. But, have some comments. Lopressor will DECREASE blood pressure, if this patient is actively dying, why continue it? I question a medical director who would approve of the patient going home with IV Lopressor.
And, the unsafe part....well, to me anyway, is the snowstorm! Given that I live in Massachusetts, I can confirm that it IS a safety issue when driving in these recent snowstorms! Just a week ago, someone passed me, going WAY too fast in a snowstorm, and lost control and crashed into a telephone pole in front of me....the person was fine, but the car was totalled.

if this med'l dir was advocating for pt to die at home, i applaud him.
sure, lopressor will decrease bp, as will morphine and sev'l other meds.
i 100% support pt going home to die.

leslie

[Em1995]

I applaud him or her, too...but, why complicate matters and continue futile interventions (lopressor). With good family support, (I assume the hospice admitting nurse was at the hospital to assure support to transfer the pt home), usually the family can be educated and supported to d/c unecessary meds/procedures....or, maybe I missed something.

[earle58]

w/o knowing, i'm 'thinking' pt made hospice while in hospital.
let's say primary (hospice) dx was lung ca.
but needed iv lopressor for her (separate) dx of chd.
if hospital md agreed to discharge her to home (to die), i'm sure he's trying to maintain cardiac status...
let her die from lung ca.
this may allow time to get loved ones over and say good-bye.

leslie

[Angie O'Plasty, RN]

The Lopressor would've dropped the BP, but overall, the beta blocker would help the heart by slowing the rate. Suppose the patient's heart rate without the Lopressor was say, 150-160? Too fast to support someone in such a depleted state. If you take her off, she'll die before she gets home -- and she wants to die at home.