Lasix gtt

[brissie]

Just curious how often you check a K on a pt with a lasix gtt. I had a situation at work the other night where a pt was on a Lasix gtt at 10ml/h and apart from the occasional PVC was SR w/ no ectopy, well shortly after getting report and just as I was walking into the pt's room they had about a 8 second burst of V.Tach. Checked a K and it came back 2.8. I looked back and a K hadn't been checked for 16 hours. Last K was 4.3. Anyways just wondering if you had a unit policy for pt's on a Lasix gtt or if was just left up to the individual to check electrolytes periodically.

[BBFRN, BSN, PhD]

I believe we did it q6h on our unit (or more, if needed or if fresh heart).

[ghillbert, MSN, NP]

Depends on the urine output. Some people are more/less sensitive to lasix, so I'd judge it on the output. If over 100ml/hr, I'd want to check it reasonably regularly.

[anurseuk]

I work in a cardiothoracic critical care; usually I would check the k every couple of hours, maybe more or less regularly depending on the individual patient... there condition... there response to the lasix.

16 hours seems really negligent.

we have k levels on our gas machine so it's easily obtainable and 99% of our patients have central lines so easily corrected.

hope that helps...

[Cindy-san]

If my pt is on a Lasix drip, I usually check labs at the start of my shift, unless replacements are going in, then I wait until that's done and recheck (it's policy and a standing order to recheck lytes after replacing, not to mention good practice, and it annoys me something fierce when other staff doesn't do it. The pts have lines, there is no reason for not following the orders). If the K is ok, I'd recheck in 3-4 hours or sooner if I notice ectopies.

I usually find Lasix drips make it a check-replace-recheck kind of night.

[SEOBowhntr]

I've checked at both q4 and q6, but always had the option to check more often if rhythm changes occurred.

[SWEnfermera]

As both a traveler and as a staff nurse I've never worked anywhere (other than in post open-heart units) that had standing orders for K checks. As others have posted, you have to consider the dose of the drip and the patient's urinary response.

Just another note, be careful with patients who are receiving frequent or continuous Albuterol Nebs. Albuterol can significantly lower Potassium levels.

[gilf7243]

This has happened at my hospital before. Someone is on a K+ depleting drip and no one thinks about the K+ level. I think it should be protocal to check a K+ level daily when on a drug like lasix or bumex. I work night shift so it irritates me when the day nurses don't think about these things when the docs round and you come on night shift and by the time you have a chance to fully examine the patients labs, tests, etc it is too late to call the doctor and you get an on-call doctor that doesn't know anything about the patient. Especially, if they start having arrhythmias. Normally a lab order is given when asked but in general it just irritates me when day shift doesn't catch things. Happens a lot at my hospital.