Is taking diuretics equals having CHF?

kanzi monkey · Mar 13, 2011

SOB on exertion is a sign/symptom of pathology (of what pathology depends on the whole clinical picture). "Age" isn't a disease that creates pathology. I know I'm not answering your question, but I'm just responding to your comment that SOB "could be age related". Don't go down that road. They may live with it chronically, but it's a symptom of disease (for which they are probably being treated, and which MAY have to do with the meds you mentioned, but you can't know that unless you know the patient's diagnosis).

mappers · Mar 13, 2011

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).

A little OT, but how many people have heard people say that when the here Congestive Heart Failure, they assume the person has fluid around the heart. I've heard this a lot. As a matter of fact, I thought this myself before I went into nursing.

People hear congestion and think fluid, then heart, and think fluid around the heart. I try to explain that it's more the heart pump, not working properly, causing congestion in other parts of the body.

Altering the name, might be a good idea.

KJStarling · Mar 13, 2011

Well, Gosh if diuretics=CHF, I guess I get CHF one week out of every month. Is that why my jeans feel tight and I get so cranky? :rolleyes:

Just kidding! I think checking to see why a patient is taking a med is very important, and some of your patients do take a diuretic as part of their treatment of CHF, but many more patients take diuretics for other conditions (like me, for PMS) and some CHF patients may not take a diuretic at all!

leslie :-D · Mar 13, 2011

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

i'll agree that many make the association betw lasix and chf...but there are also many other indications for its use.

are you filling out some type of form, where reimbursement is based on the dx/meds of the pt?

if you are, never (NEVER) put anything down unless you are 100% sure.

leslie

Blackheartednurse · Mar 13, 2011

i'll agree that many make the association betw lasix and chf...but there are also many other indications for its use.
are you filling out some type of form, where reimbursement is based on the dx/meds of the pt?
if you are, never (NEVER) put anything down unless you are 100% sure.
leslie

Actually thank God I'm not responsible for that, my boss, DON fills out that part of the form.

Blackheartednurse · 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.

Yes, I work home health.I recall reading that coreg is often used for CHF patients, when the patient take ASA i usually think of a stroke or CAD,previous MI, poor circulation.

nursej22, MSN, RN · Mar 13, 2011

Yes, I work home health.I recall reading that coreg is often used for CHF patients, when the patient take ASA i usually think of a stroke or CAD,previous MI, poor circulation.

I meant to say the the combo of lisinopril (or another ACE I or ARB), Coreg (or Toprol ) and ASA would make me suspicious of a dx of heart failure.

Yes, ASA is used to treat many conditions, just as lasix is :) .

FWIW, other meds one might see for heart failure in the home setting are spironolactone, epleronone, digoxin, nitrates, and hydralazine. We have also sent home pts on IV milrinone. These are usually end-stage or transplant candidates.

Blackheartednurse · Mar 13, 2011

I meant to say the the combo of lisinopril (or another ACE I or ARB), Coreg (or Toprol ) and ASA would make me suspicious of a dx of heart failure.
Yes, ASA is used to treat many conditions, just as lasix is :) .
FWIW, other meds one might see for heart failure in the home setting are spironolactone, epleronone, digoxin, nitrates, and hydralazine. We have also sent home pts on IV milrinone. These are usually end-stage or transplant candidates.

I'm surprised that I havent seen much of digoxin.In nursing school digoxin was discussed to ad nauseum, yet in a home health or hospital settings I havent seen much of it.I visit couple of patient with the diagnosis of CHF and non are on digoxin (cause it is toxic?) and I had only one patient that was on it.

OleMissRN · 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

No, CHF is diagnosed via ECHO or PA cath readings. Those are the only two ways that you can reliably diagnose CHF.

Sugarcoma, RN · Mar 14, 2011

Digoxin is not a first line drug for CHF and many docs choose not to use it. It has not been shown to prolong life and in fact for women it may contribute to mortality. Add to that the multitude of side effects, interactions, and fairly complicated follow up of a patient on dig (lab monitoring, diet restrictions,etc.) along with the fact that there is a very thin line between therapeutic and toxicity, it is often a last choice for symptom management. We very rarely see pt.s on dig anymore.

Just to echo what others have posted diuretics in combination with a CCB or beta blocker, ARB, etc. are often used to treat hypertension. A diuretic in addition to these other meds can help minimize the bodies reflexive response to the anti-hypertensive medication.

SOB on extertion and edema are symptoms of many conditions and do not necessarily point to CHF even if the pt. is taking a diuretic and other meds.