IV Bumex in home?

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Specializes in COS-C, Risk Management.

Background: elderly fragile CHF pt with weight gain of over 10# in 1 week since admission, tight lungs with bibasilar crackles, 3+ BLE pitting edema, regular meds include Bumex 2 mg PO BID.

Today, doc orders additional 3 mg Bumex IV push x 3 days (over the weekend) to be given in addition to regular PO dose. Pt does not have any K+ replacement ordered and no labs ordered. That's a total of 9mg/day of Bumex without K+ replacement and metabolic labs ordered. What say you experienced home health nurses?

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Specializes in Home Health, Med-Surg, Ortho.

Did you bring that to the doc's attention (no K+ replacement / labs)?? Did they insist on it anyway?

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Specializes in COS-C, Risk Management.

After speaking with several IRL colleagues, including 2 pharmacists, I refused to give the medication. Too many factors that I felt were unsafe to play with my license, IMHO. Although I've already turned in my notice, I have a sneaking suspicion they may fire me over this one--fine, I could use the break.

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After speaking with several IRL colleagues, including 2 pharmacists, I refused to give the medication. Too many factors that I felt were unsafe to play with my license, IMHO. Although I've already turned in my notice, I have a sneaking suspicion they may fire me over this one--fine, I could use the break.

WOW, what ever happened about this? I'm pretty sure my administrator would not feel this client was appropriate for home health if that was his only treatment option.

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Specializes in COS-C, Risk Management.

They got a PRN nurse to do it the first day, but B/P was so low next day pt went to the hospital where they didn't keep pt. PRN nurse refused to give further doses. Pt now in hospital with fluid overload, renal failure, etc. I don't feel bad about my decision in the least and they didn't fire me. Darn. I was hoping for a few days off. ;-)

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They got a PRN nurse to do it the first day, but B/P was so low next day pt went to the hospital where they didn't keep pt. PRN nurse refused to give further doses. Pt now in hospital with fluid overload, renal failure, etc. I don't feel bad about my decision in the least and they didn't fire me. Darn. I was hoping for a few days off. ;-)

You certainly called that one. I wish the doctor had placed pt. in the hospital to begin with. Have a great weekend!

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