palliative pt

  1. I am a nursing student and today was my second day in clinical. I cared for a 98 year old lady who came in with aspiration pneumonia. her ongoing health challenges also include alzheimers, osteoperosis and CHF.

    Basically my problem has been that this lady is NPO and receiving no IV hydration only IV antibiotics. Her family keep questioning why she is receiving no nutrition and fluids. They feel she is suffering from dehydration and malnutrition. The nurse explained that she can't receive fluids because it will simply go straight to her lungs.

    is it the dr's responsibility to explain this to rhe family or nurses?
    and how can I find the words to explain this to them?

    I'd appreciate any help
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  2. 1 Comments

  3. by   leslie :-D
    this is not your responsibility to tell the family anything.
    it is the sole responsibility of the md.
    is she officially on hospice/palliative care now?
    it is true: receiving iv fluids would only add to the resp distress.
    if she is truly comfort care, then it's a wise decision.
    being 98 with asp pneumonia and chf, i'm sure she's struggling.
    if her circulation is compromised, any fluids would indeed go directly to her lungs and she would drown on her own secretions.
    also, once your body is malnourished or dehydrated, there is a release of endorphins that give one a natural 'high' if you will, deflecting from any potential discomfort.
    truly, the md just needs to have a 1:1 with the family to appease any anxieties/fears.
    if the nurse feels comfortable enough with what s/he knows, then s/he too can try and allay their concerns.

    leslie

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