Lasix

[Jay2daq]

Im actually a nursing student, but quick question on Lasix.

I had a pt. that was clearly in some sort of respiratory distress....respirations 40, loud wheezing, i heard no lung sounds, doctor had ordered a Lasix P.O.

Does Lasix help clear up respiratory secretions?? I always thought it was edema, CHF, blood pressure.

After his Lasix he was fine!!

Thanks!

[ghillbert, MSN, NP]

It resolves pulmonary edema by making them pee out the fluid so they can breathe easier.

[CFitzRN, ADN]

CHFers tend to get pulmonary edema, so you're right - it is usually CHFers and such who get it, but he was having the same symptom as a CHFer, and the Lasix worked the same way it would for someone with CHF.

[cherrybreeze, ADN, RN]

It's not respiratory secretions, per say, but fluid in the lungs, yes...so that's what your patient's problem was. Wonderful how it can work sometimes, isn't it?

[Flame_07]

Lasix gets rid of pulmonary edema also, I wonder if he had potassium ordered, because lasix is potassium wasting so after he starts getting rid of the fluid he will loose potassium or was it a one time order?

[diane227, LPN, RN]

You will not necessarily administer potassium with a one time lasix dose. It is important for you to know the history of this patient in order to monitor and care for him/ her properly because one dose of lasix is not a cure for this issue. It is a stop gap measure. It would be important for you to know if this patient had a cardiac history, CHF, heart failure and what his/ her current level of heart function is (ejection fraction). Also, does the patient have any abnormalities on the EKG that would reduce cardiac output? Does the patient have right sided heart failure? In addition, what is the patients baseline renal function and respiratory function... smoker, copd, sleep apnea, obese, etc. When you have a patient who develops these symptoms acutely you have to be aware of all potential causes and know how to monitor the patient properly.

[netglow, ASN, RN]

OP, just go back to your A&P book on that one, and there you will have your understanding. Look up CHF, probably mostly left-sided.

[Emergency RN]

CARDIAC ASTHMA is a diagnosis that loosely describes the pulmonary presentation of some patients with Congestive Heart Failure, in which they present with Shortness of Breath, Wheezing and Cough; ie. symptoms usually seen more in the typical acute asthmatic attack. It is not Asthma in the true sense (with bronchial constriction) but rather fluid seepage into the lungs. The fluid narrows air passages and audible wheezing can then result, mimicking an asthmatic presentation.

The treatment of choice here is to drop preload (amount of fluid returning to the heart). One can do the above with dilation of the venous bed (Nitrates, Morphine) or by elimination of excess fluid (diuretics), which in turn lowers fluid return to the heart. PO Lasix, a Loop of Henle diuretic, rids fluid over time, while an IV dose acts rather quickly. I also agree with respondent Diane227 in that a one time dose of p o Lasix, is unlikely to lose potassium to the point where replacement is needed.

***Sidebar*** Respondent Diane227 also highlighted a good assessment point in noting the need here for an EKG. Many diabetics, because of their disease neuropathy, fail to ever have a warning sign of chest pain. Their first inking of the onset of Myocardial Infarction is sometimes limited to the shortness of breath induced by their suddenly failing heart. Because of this rationale, it is always prudent for any acute episode of dyspnea to be assessed by electrocardiogram.

[FowLaf24/7]

As one progresses in the understanding of the disease process of CHF, one will begin to understand the reason for the respiratory effects. Lasix is for edema. What is edema? Excess fluid which has leaked out of the vascular system (capillaries.) One has capillaries in their lungs. Right? Excess fluid will leak from these capillaries too, causing the respiratory effects. CHF is one disease process, where the the heart not circulating blood to the kidneys (and not doing a very good job with the rest of the body either.) The body's compensation response has the kidneys begin to hold onto excess water and secrete angiotension, which later is transformed into angiotension 2. Angiotension 2 causes the vasucular system to constrict. Angiotension also communicates to the adrenals to produce aldosterone. Aldosterone is secreted which causes the kidneys to hold onto the salt. Where salt goes... water comes with it. So, excess fluid accumulates with vacular constriction which translates to leaking of the capillaries into the third space. This fluid can not be reasbsorbed. The only way to get rid of the excess fluid is by the medication Lasix, or something simular.