[Suesquatch]

http://www.kennedyterminalulcer.com/Photos.htm

Thanks. I didn't know about these.

[mschelee]

[quote=CANRN;2839950]I tried that and was shot down. As I pointed out on the CRF and the H&P, he was hospitalized twice in two monts for Respiratory Failure. THe documentation clearly supports it. I was told, "there is no history of COPD" I was thinking to myself "WHAT THE?


Respiratory Distress/SOB and Respiratory Distress Syndrome NOS are both Hospice Diagnosis' that we use here.

~C

[CANRN]

[quote=mschelee;2889342]

Originally Posted by CANRN

I tried that and was shot down. As I pointed out on the CRF and the H&P, he was hospitalized twice in two monts for Respiratory Failure. THe documentation clearly supports it. I was told, "there is no history of COPD" I was thinking to myself "WHAT THE?


Respiratory Distress/SOB and Respiratory Distress Syndrome NOS are both Hospice Diagnosis' that we use here.

~C

Thanks!! I had not heard of these.

[Sabby_NC]

I have not read all the posts but is he not appropriate for his Dementia then have the respiratory distress as a secondary dx?

Get your CHPN and fly the coup CANRN.

I did my CHPN last year and what fun that was LOL

Although the group of us that went from our organization thought the exam umm errrrrrrrrrr sucked LOL

Still we all passed.

[piggypoke]

I am shocked but I have also ran into these situations. I would have went with respiratory failure.
I am not sure what state you are in or what your guidelines are, but he would definitely qualify for end stage pulmonary disease. You should have a pulmonary worksheet that is generalized enough to use. He is going to pass away before anyone gets their stuff in gear.

[calliesue]

Thanks Sue, for the Link to Kennedy Ulcers.
I had never heard of them before . I learn something every time I come to all nurses .

[MSMM1950]

Hospice Diagnosis would be Alzhiemer's Dementia. This is the terminal illness which will cause his demise. Co-morbidity affecting prognosis would be Respiratory Disease. Document Karnofsky score (sounds like his might be 30%) and FAST score (sounds like his would be 7). Document any recent infections, i.e. pneumonia, urinary tract infections etc. Document nutritional status and weight loss in last 3-6 months. Document history and circumstances of recent decline. Admisson for symptom management and continued assessment are certainly appropriate.

[MSMM1950]

Doesn't matter what state your in...guidelines are dictated by Medicare.

[NurseAlwaysNForever]

Why not just use ES Alzheimer's. If the resp distress is secondary to that?

[chele9633]

I know this is a last posting but i think i would have probably used End stage dementia or Alzhemiers. B/c he could have had some aspiration pnemonia which lead to resp distress. If he can't swallow, a total for all adl's and possibly been treated for a uti recently and has had a weight loss, i think that DX would fit him. Thats what i would go with. Also it sounds like you have documnentation of a decline all based on is advancing dementia. I don't know, just an observation!! thanks michele