Quote from jandb917
well i just thought it was odd that they were sending her back to the nursing home when they just brought her into the er today and she had congestive heart failure twice already today and then found out she has pneumonia on top of that plus the fluid around her heart i thought they would keep her for observations plus she has parkinsons disease plus she has had a trache for years too
You said she had 'congestive heart failure twice that day'. CHF is a chronic condition that a pt is diagnosed with and must be managed long term. Pts often have CHF exacerbations that bring them to the hospital...Shortness of breath due to pulmonary edema. Therefore, I think you are confused.
Why was this pt initially brought to the ER? What was her chief complaint? For example, SOB, fluid retention, Chest pain, Fever, Change in Mental status, etc. After she received treatment, were her initial symptoms stable....SOB/CP relieved, Fever absent, Mentation clear, etc....whatever went along with her diagnosis.
I think that you can't see the forest for the trees. LOL. You seem very concerned about her individual disorders...all of which are chronic and can be managed at the nursing home (CHF, parkinson's). This pt probably has had fluid around her heart for awhile...otherwise, I think they would have done a pericardiocentesis and hospitilized her. Probably nothing to be concerned about. No need to get worked up about a pt that has had a trach for two years, unless they are currently experiencing complications that need immediate intervention. It is common for pt's to be trached longterm. The only thing that I see as a concern is the pneumonia...probably secondary to the chronic pulmonary congestion. If the pt's vitals were stable and she recieved antibiotics...then it's perfectly acceptable for her to return to the nursing home for continued care.
You need to get a feel for what your pt's quality of life was before the admit, what changes brought the pt in, what was done to alleviate those complications, and try not to get hung up on all the pt's chronic disorders.