Hi there, I am an nursing student working as an ESN (Employed Student Nurse) in an acute medical unit. Today I worked with a pt who was 78yrs old with fluid overload. His admitting diagnosis was urosepsis. He had a pacemaker, and had a CABG done in 1982. When I came on shift his IV was running NS at 100cc/hr. As the day progressed, his breathing became wheezy, his lungs full of crackles on auscultation, and he appeared pale. I suspected fluid overload. I notified the doctor, and the doctor ordered discontinue IV, and give lasix 40 mg IV push. 30 minutes passed, and patient was not diuresing. The doctor ordered another 40 mg to be given IV, and for foley to be inserted. Again, patient is not diuresing. Latest lab work showed normal GFR, normal Creatinine. In total, the patient received about 260 mg Lasix today, and only outputting 125cc of urine through foley. We did a random bladder scan, and the scan showed 15cc of urine in the bladder. Blood pressure throughout the day was normal, heart rate was 80 to 105, Resp was 36, Temp was 37.2, and O2 sat was 82% on high flow oxygen (100% O2). The doctor also ordered morphine 2.5 - 5mg SC q1h PRN, and atropine q4h prn. Comfort measures the declared by doctor. My question is: why is the patient not diuresing after given a lot of lasix when his GFR and Creatinine levels are normal? Thanks, SP