Lasix use in CHF?

[gorgenurse]

Hello all,

I am a new hospice nurse and I have a question about using lasix for CHF once a person is admitted to hospice. I just admitted a pt last night with CHF. She spends most of her time in bed at this point, but does get up occasionally. She has round the clock caregivers. After being put on hospice her lasix (among other meds) was DC'd. My question is, is lasix always DC'd once a CHF pt is admitted to hospice? She does not have any extremity edema at this point, but she does have crackles throughout in her lungs. I am just wondering, as she starts to fill up, would lasix ever be used? Or would that be considered active treatment and not letting nature take it's course?

Thanks!

[tewdles, RN]

In my opinion the lasix should not have been DC'd at admission. Lasix is "addictive", at this point taking her off of it is likely to cause unpleasant and undesired symptoms that will complicate the dying process.

[Alvindudley]

Here's what you need to remember about CHF and hospice. This comes from a colleague of mine who heard it a conference but it is wonderful. The goal is to have a metabolic death, not a congestive death. Death by dysrrythmia is far preferable to drowning in fluid from flash pulmonary edema. Lasix is a major player in comfort measures at EOL for our patients.