LASIX/ECHO questions

Any thoughts would be greatly appreciated, especially any ideas as to what sources/ textbooks/written nursing standards might apply (this is NOT for a homework assignment)




Is it contraindicated to give Lasix IV immediately before a non-emergency Echo test.

If Lasix IV is given immediately before an Echo test, what conditions would be necessary for the patient's safety and comfort during the conduct of the Echo test ?
Okay, I'll be the Devil's Advocate here. Is this a transesophogeal, transthoracic, or stress echo? What are you worried that might happen?I suppose, if the patient dumped a TON (liter or more) of urine, you might have problems with K+ or blood pressure, but not for an hour or more after you give it. None of that would relate to the echo unless it's a stress test. That's all I can come up with off the top of my head.

Sounds like homework, yesserrie it do!

I was thinking that the administration of Lasix might cause a variance in the readings of the ECHO due to the fact that BP might change because of the sudden start of diuresis? Also who wants to have to pee suddenly in the middle of an ECHO!Just my avenue of random thought.To elaborate: Patient has some kind of valve degeneration but due to the sudden decrease in fluid volume/BP the dysfunction isn't as visible? (I am definitely not an ECHO tech and completely just thinking out loud.)

i'm thinking that there are two possibilities why this would be a bad idea. one is that a good diuresis will make the venous return lower, which in people with chf would make their normal myocardial contractility better (optimize them on their starling curve) (ask me if you don't know about how this works -- it's the reason people get diuretics for chf, since it addresses the cause of the c in chf ). this is a good therapeutic effect and what you want to have happen in chf, but if the echocardiogram is being done to see what their response to exercise is and you have made their contractility temporarily better, then perhaps the results would be misleading. the echocardiogram should be done under the heart's normal working conditions, so to speak, to document decreased wall motion and valve stretch, for example. i'd ask the md about this, to be sure that the diagnostic test isn't going to waste. be prepared to be blown off, because the md may not have thought about the timing on this either, but let the echo dept know and be sure it's prominently charted in your notes that it was given just before the patient had the echo. the second is that it's a drag to be downstairs having an echocardiogram and you have to pee, and in fifteen minutes you have to pee again, and again soon thereafter. i'd actually care more about the cardiovascular status from a diagnostic standpoint, but it's rude to give furosemide before a road trip.oh, yeah, and what she said about the potassium. if this person is prone to ventricular dysrhythmias, a big drop in serum k+ might not be a great idea because it will make it easier for those to occur, and you probably don't have time to deal with ventricular tachycardia this morning. make sure the morning k+ was ok before you give the furosemide, and be sure patient gets oral/iv replacement before hitting the road. if it's not ordered, ask.

Quote from dseltzerAny thoughts would be greatly appreciated, especially any ideas as to what sources/ textbooks/written nursing standards might apply (this is NOT for a homework assignment)Is it contraindicated to give Lasix IV immediately before a non-emergency Echo test. If Lasix IV is given immediately before an Echo test, what conditions would be necessary for the patient's safety and comfort during the conduct of the Echo test ?

OP: Does the pt have a Foley? and does he have CHF? (or suspected). Then again, if the pt does have CHF as well as chronic renal failure, the dosage of Lasix given may not be enough to do squat anyway!