Have you ever seen this before?

Nurses General Nursing

Published

Have you ever seen a patient receive 80 of lasix IV push and not make one drop of urine? The patient did have renal failure but still...I always thought lasix worked no matter what. I am a new nurse but I have never seen this, and none of the experienced nurses I worked with have ever seen it either. One even asked me "Are you sure you gave the lasix???"

Can anyone give me a quick explanation of how this could happen? It's really bothering me and I can't find any information anywhere. I am so curious about what could have happened.

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Specializes in Community Health/School Nursing.

The way I have understood Lasix has the potential to make kidney issues worse. It produces large amounts of urine but if you already have an isssue of actually passing the urine then that's where the problem starts.

Someone please correct me if I'm wrong. ??

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Specializes in Med Surg, Float, Travel.

Yeah that happens sometimes. Renal failure patients lose the ability to produce urine because their kidneys literally stop functioning. Many renal patients are anuric, & dialysis does the work that their kidneys can't to get rid of the excess fluid. If this is new onset, sounds like this cat need to get his butt to dialysis!

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Specializes in Med Surg, Float, Travel.

You're 100% correct wavewatcher, yes indeedy!

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Specializes in Community Health/School Nursing.
You're 100% correct wavewatcher, yes indeedy!

Yay me! :yeah: I haven't worked with renal patients in a long time but my pea brain pulled through!

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Specializes in Oncology/Haemetology/HIV.

I've seen them get 200mg of lasix and not urinate.

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Specializes in ICU & LTAC as RN. FNP.

If I remember correctly, years ago my critical patient didn't produce urine after alot of lasix. I remember we gave bumex, which worked.

Bumex is 40 times as potent as lasix, maybe that's why it worked...but I have also seen patients not respond to bumex either, although I don't recall what caused their kidney failure.

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The pt had been in the hospital for a week before I had her as a patient. Now I wonder how long this had gone unnoticed. My charge nurse literally thought I was crazy when I told her I was getting no output. I called the doc and got an order for a foley and when I placed it I got less than 1 mL out. Bladder scanner was totally erratic, showing anywhere between 200 to 400 mL's in the bladder. Everyone was sure I had misplaced the catheter. (When they realized it was in the right spot they advanced it all the way to the bifurcation! The poor patient!!!) Very upsetting. I called the doc and he ordered an pelvic CT. Sure enough, bladder was totally dry. The scanner was picking up the anasarca in her abdomen.

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Specializes in Nephrology.

Rule is that the if the kidneys don't work, the lasix doesn't work! Easy as that...if you want more info just open up that handy-dandy med book and look at the action of lasix and where the action takes place and you have your explanation! I wish lasix could work in renal failure...what a Godsend that would be!

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Specializes in CICU.

Agree with above - if kidneys don't work, lasix won't work.

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What was the doc thinking? :confused: (I know you don't know that- just seems asinine to even order it if he/she'd been checking the I&Os).

What have I&O's looked like for the last week? Was this a sudden lack of urine output?

Sounds like a bad situation... especially if the CN didn't think about no product coming out of a dead factory. JMO. :)

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Specializes in ED/ICU/TELEMETRY/LTC.

I've had lasix not work when it was pushed, the doctor then ordered a lasix drip. The best I can remember it was about 10 or 20 mg an hour. Not sure of the concentration. But anyway, this guy who has little to no response to the push lasix, had massive output on the drip.

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