Quote from mlauren
If a patient has heart failure, is on lasix, and has decreased bowel sounds and muscle weakness, would you give a potassium sparing diuretic or 20 meq/l potassium?
Could you guys help me understand why you would choose one or the other?
I would think that giving a potassium sparing diuretic is best, because the patient needs the diuretic (Excessive fluid volume), but needs to keep the potassium. If you just give the patient extra potassium they're still going to excrete it, because of the lasix correct?
Patient Condition: Heart Failure
S/S: decreased bowel sounds (hypoactive), muscle weakness
Which med to give, lasix or 20meq/L potassium?
I can see why you would ask about lasix. However, I don't understand why you are asking about potassium? What is the level? Are you implying that the other S/S are caused by hypokalemia hence the potassium administration?
They may have hypoactive bowel sounds for a number of reasons. For instance, immobility, narcotics, bedridden, some GI issue, etc. Also, muscle weakness can be caused by being simply lethargic or a vast number of other conditions (i.e. Electrolyte, Hematological, Cardiac, etc.) or the heart failure.
Or, I imagine one could be on both medications: lasix for the HF and potassium replacement for the lasix, I believe this to be feasible. Patients are given medications all the time for the side effects. For example, stool softeners for narcotics, electrolytes for diuretics, antinausea for many medications.
Is lasix (a K sparing diuretic) best?
This idea struck my interest. I did a quick scan of a research paper comparing diuretics and generally when which diuretics are indicated.
It seems thiazides are first line to loop. And, kidney function is evaluated when using diuretics (like any other drug).
How about a what if?
What if your patient has hypokalemia but still is prescribed lasix? Or, if the patient is given extra potassium but is prescribed lasix?
I would imagine, if the patient has hypokalemia, and is prescribed lasix, we would hold the medication and call the MD for a potassium rider (if there isn't an order already).
Anyway, here's the paper I found if you're interested in reading it.