Furosemide & KCl

[OwlieO.O]

I'm a med aide (and future nurse). I noticed my patient was just put on 120mg QD furosemide for Dx edema. He is not on any KCl. Also, this man is a frequent imbiber of alcohol and coffee. Should I be concerned about catastrophic hypokalemic? My nurse doesn't seem interested at all by this, so I wanted to ask here.

[OwlieO.O]

Hypokalemia*

Autocorrect fail

[Esme12, ASN, BSN, RN]

Is this patient renal impaired? That is TON of Lasix!!!!

Unless they are severely renal impaired.....yes this is something you should be concerned about. You know what...yes you shoould keep this on the radar.

[OwlieO.O]

Is this patient renal impaired? That is TON of Lasix!!!!

Unless they are severely renal impaired.....yes this is something you should be concerned about. You know what...yes you shoould keep this on the radar.

He has a Hx of a malignancy in his colon, but often has frequent loose stools and is pretty regular.

[akulahawkRN, ADN, RN, EMT-P]

That's a LOT of Lasix. The patient's K+ level is something that you should keep in mind, even if the patient's kidneys aren't doing well. Why? They shut down completely and the patient can't get rid of K+ very well...

Definitely keep that in mind.

[SierraBravo]

I agree with the above comments. I also hope that the patient is ordered for labs at least q24h. If it's not a dialysis patient, I would also be more comfortable if the patient had an order for prn electrolyte replacements. For patients that are chronically low in electrolytes, I have seen orders for BID electrolyte replacements.

[yoga pants]

Why isn't the nurse worried about it? That is a lot of lasix, but maybe she knows something you don't know (like the pt's K+ level) or like a previous poster said, has orders for prn lyte replacement or a sliding scale lyte replacement protocol.

[Esme12, ASN, BSN, RN]

He has a Hx of a malignancy in his colon, but often has frequent loose stools and is pretty regular.

Yes you should be concerned over replacement

[Mr. Murse]

As someone else said, first thing I would look at is the current potassium level. I've seen that much lasix given from time to time, but there are too many unknown factors here (as readers on this thread) to say for sure what's going on.

[Nursing Is My Life]

I was taught that if a patient was on Lasix then they should be on KCL as well, lately I've noticed that a lot of my residents receive Lasix but aren't on KCL. so has this changed?

[Been there,done that, ASN, RN]

Most likely .the patient requires the high dose Lasix because he has renal insufficiency.

As you assist with the medication administration, the nurse should give you the information you requested.

[june2009]

I would expect that someone on that high of a lasix dose is getting at least a BMP on a regular basis. If you are giving that medication you have to know a current k+ level. The nurse should give you that lab value . I would also want to know a current BUN/creatinine level. That's a LOT of lasix and I've never seen that much given daily for more than a few days at a time. (Eg. Increase lasix to 120 mg daily X 3 days). You have a right to know this information.