[discobunni]

We've all had this patient in our NICU. This baby was born with gastroschisis. To make a long story short: He had all of his organs placed back, but had bouts of diarrhea and vomiting. They tried formulas with AR, but then determined there was a hiatal hernia. That was corrected, then he began gaining weight. He kept having this ugly lime green diarrhea. He was about to be discharged on my assignment when I mentioned the funky diarrhea he began having again. They did a culture and it was C-diff. He has been there an additional two weeks. He is about 2 months old now. He is still having this horrid diarrhea, is negative for the C-diff now, but they are about to send him home with it. His poor bottom is so excoriated now I've been told (I haven't had this asssignment since he was about to be DC'd) and seems like dumping syndrome. Shouldn't they be doing more investigative stuff like abdominal CT scan or something to try and figure this out before sending him home like this? He is failing to thrive and has been on a downward curve with the weight loss since that day. Has anyone experienced this before, or can someone lend any information about this type of situation? I am a green nurse, fresh out of school, and don't want to overstep my boundaries if I am wrong.

[justjenny]

Can't really speak to this pt in particular...but our belly kids often deal with feeding intolerance, etc. for a long time - and that is without C-diff being thrown in to complicate things.

My advice is this: whether you are a new nurse or not - if you feel in your heart that you have a legitimate concern about your patient and can back it up with rationales as to why you feel that way - SPEAK UP! I have not been afraid to question a Neo on a course of treatment IF I can explain WHY I feel this way.
Your job is to advocate for your patient for the best possible outcome. Do what you feel is right.

Jenny

[NICU_babyRN]

Deft. speak up!!!
There has been a really big increase in the number of gastroschisis cases nationwide and too many of them are not being managed properly-the end result could be devastating. If you feel strongly about the case, advocate for the baby!

[cathys01]

When I worked neonatal, we wouldn't send a kiddo home that wasn't gaining weight (and certainly not one that was actively losing weight). Say something!!