Is taking diuretics equals having CHF?

thehipcrip · Mar 13, 2011

Lasix (lasik is a type of corrective eye surgery) and other diuretics are prescribed for conditions other than CHF, including high blood pressure, liver disease and kidney disease. Taking Lasix on its own is not sufficient evidence for assuming someone has CHF.

sunnycalifRN · Mar 13, 2011

This question has been bothering me for a while, I noticed that is assumed that the patients who takes HCTZ or lasik suffers from CHF? Did you run into assumptions like that? Should there be any othe symptoms beside taking diuretics like swelling of the extremities, sob,fatigue.

Sorry, I take Hctz in combination with valsartan for hypertension . . . no CHF here. I've never heard of such assumptions.

Mulan · Mar 13, 2011

CHF is one of the core measures, requires discharge education and in one hospital that I know of staff have been told to look at diuretic use as a possible indicator, so that may be where that comes from.

Blackheartednurse · Mar 13, 2011

Sorry, I take Hctz in combination with valsartan for hypertension . . . no CHF here. I've never heard of such assumptions.

But what about if patient is SOB on exertion (could also be age related ) and has an edema, but no chest pains.I mean does edema plus lasix, or any diuretics equals chf.

I have heard many such assumptions from co-workers, instructors,bossess and finally medicare reimburst patients diagnoses based on medication

sunnycalifRN · Mar 13, 2011

But what about if patient is SOB on exertion (could also be age related ) and has an edema, but no chest pains.I mean does edema plus lasix, or any diuretics equals chf.
I have heard many such assumptions from co-workers, instructors,bossess and finally medicare reimburst patients diagnoses based on medication

Just review CHF in your pathophys book or google it. There's lots of info out there:

http://www.heartcc.com/chf.htm#Signs%20and%20Symptoms

neuroms · Mar 13, 2011

I have never met a nurse who makes that assumption. Diuretic therapy is appropriate for many, many clinical conditions. Also note that diuretic therapy is not a sign of illness or injury as pain, SOB, or edema are; it has been prescribed by a care provider with a specific diagnosis in mind. There are other diagnostics used for CHF like echocardiography to determine CO and EF and serum BNP lab values.

merlee · Mar 13, 2011

I have had dependent edema for many years, without HTN or CAD, and was on a diuretic long before either of those roared into action.

ukstudent · Mar 13, 2011

Co-workers, instructors, bosses and patients do NOT diagnoses if a person has CHF. That is done by doctors or nurse practioners based on their assessment of the patient, they will then prescribe medications needed bases on that diagnosis. Not the other way around. If the patient you are looking after has CHF it should be written in the chart.

nursej22, MSN, RN · Mar 13, 2011

I believe the OP works in home health and probably does not have ready access to an MD's H&P, echo and lab results.

My dear old dad has heart failure with an EF of 40% and is not on any diuretic. He is however on lisinopril, Coreg and ASA. Any patient who is on these 3 meds would make me much more suspicious of CHF than just a diuretic.

ObtundedRN, BSN, RN · Mar 13, 2011

May I add: Those other symptoms the OP mentioned could be from a number of things. Perhaps the leg edema is from poor venous return, and the SOB from COPD, asthma, some other type of heart or lung condition, or volume overload from another etiology.

FutureRN9 · Mar 13, 2011

But what about if patient is SOB on exertion (could also be age related ) and has an edema, but no chest pains.I mean does edema plus lasix, or any diuretics equals chf.
I have heard many such assumptions from co-workers, instructors,bossess and finally medicare reimburst patients diagnoses based on medication

The only condition that equals congestive heart failure is congestive heart failure (in fact, there is a theory of thought that is using the term heart failure and differentiating between left and right instead of the term congestive heart failure).

The defining characteristics of SOB on exertion and edema do not necessarily equate to heart failure. For instance, the possibility that the edema and the SOB are not related or possibly in no relation to the heart. Consider checking lab values (Creatinine, BUN, B/C ratio, GFR, Albumin, ABG's .. just to name a few. Specific labs are going to depend on your patient). It very well could be that they are in renal failure (or having some other type of renal disease) and their albumin is low, in turn causing third-spacing. Renal failure could also explain the SOB .. think pulmonary congestion (edema). Also, as stated above diuretics can be used to treat several different conditions. Most medications have several conditions that they are used to treat and it is more important to know about the medication (S/E, A/E, Therapeutic Management, Contraindications, etc) than to assume you know why the patient is taking that medication.

As a nurse it is very important to understand that your patient will present with his/her own set of signs and symptoms. Nursing school gives you the basic knowledge to help you assess these signs and symptoms, but you must treat each patient as their own case.

This is my opinion: I feel that you do not only a disservice to your patient but also to yourself by making assumptions like this. I say this because I want you to progress, not at all be offensive .. I would not want you to be my nurse because I feel like you would see one thing and might miss other important assessments. I am in NO way implying you don't have the capability to be a wonderful nurse, but I would hope you are able to broaden your focus of assessment and evaluation.