blood monitoring during Lasix administration

[watchgoose]

Hypothetically, how would I rate a physician who would not take blood occasionally to monitor potassium when administering 80mg Lasix bid to a patient with CHF?  I'd really like to know.  Thank you.

[Douglas Bogart, MD]

I agree that the lab work needs to be monitored and the kidney function should be checked as well as the electrolytes.  I think your friend needs a new doctor!!

[BigBirdinAL]

Hypothetically...any physician you are uncomfortable with warrants you seeking the advice of another physician or a second opinion.  In all fairness, I would specifically ask
the prescribing physician to monitor the potassium level if that is what it takes to make you comfortable. If they refuse, then maybe it is time to look elsewhere. A patients individual comfort and trust with their physician is important in their overall health, both
physical and mental.
You physician may be comfortable with this situation based on previous experience with the patient in question or for other reasons. There are also symptoms that would lead the patient to know that they are becoming potassium depleted or dehydrated and that would lead to futher testing.

[watchgoose]

Every RN I've talked to was horrified that this much Lasix would be administred with absolutely zero monitoring.  You seem pretty casual about it.  In a hospital setting, it would be done.  The patient is still the patient whether he is in hospital or at home.  When a doctor REFUSES to do bloodowork, and intimidates the patient by saying he can just find another doctor, something is very wrong.  This is an elderly gentleman who is afraid to buck the system and still sees doctors as gods in white coats, instead of (expert) hired help that they are.  
Try to fly an airplane without looking at the gauges and see how far you get.

[watchgoose]

Thank you for your response.  We had our own labs done since the doctor wouldn't do it and found the pt's potassium ok but kidney function way out of line....  very odd his own physician won't monitor.  Thanks again.