What would you think if you saw this patient? - page 5
Just curious to know what other nurses think. To me it sounds obvious, but maybe I'm missing something... Let's say you have a patient in an outpatient clinic with the following symptoms: he... Read More
Jul 19I am so sorry. I think the other posters and I all agree that this physician perhaps was too lax in his care and perhaps some accountability needs to occur. Hugs to you and your family as you get through this tough time.
Jul 23As an ICU/ER nurse, my foremost concern would be the patient's airway. It would increase my concern even more that the patient has at least TWO symptoms that individually could cause severe airway compromise. My thinking is also supported by experience providing triage to hundreds of patients that arrive to the local ER. A patient presenting this way would be required to be taken straight back to an ER bed (no waiting), ER MD called to the bedside (if not attending a greater emergency), THEN vital signs, more complete history, etc could be obtained in a more stable environment, as well as the patient being made more comfortable ASAP (if possible). It might take quite awhile to fully sort things out, esp with the patient's past history. This is a patient that should be transported from the clinic by ACLS trained ambulance ONLY, unless the patient (adult) refuses.
In reference to who brings this type of patient to a clinic... After having worked at the walk-in clinic while on light duty d/t injury (very tiny and isolated rural community, 22 bed hospital, etc), LOTS of people. Having newly arrived from a level ! trauma facility in an urban area, I too, was stunned by this phenomenon. I had to remind myself on a daily basis that I was literally privy to an abundance of knowledge that only other healthcare providers would know. It has been 17 years since I witnessed this for the first time, and have seen this happen many times since. I was reminded of it once again, while i was picking up a prescription from MY local clinic. A patient arrived (having driven himself and was alone) that was VERY short of breath WHILE using O2, dusky,etc and asked the receptionist if the clinic had time to see him without an appointment...
Thank you for the presentation of this very ill, but interesting patient!
Jul 23Quote from Orion81Quite possibly, yes. And yes. Fibroids are estrogen-fed. Unless you're menopausal, they can grow.Lol, you asked for it....
f you remove fibroids, will it create scar tissue that can prevent implantation? And if you have a somewhat small tumor, can it grow bigger over time?
Jul 24I would need more assessment data to decide. How are his vital signs? What is his PMH? What you are describing could be a stroke, or it could be bells palsy or any number of other things. My gut leans toward sending him to ED for further assessment, but I don't have the entire picture here from your post.
EDITED TO ADD: Now that I read through some more of your postings and see the hx of brain cancer I would have opted for sending the patient to the ED via ambulance.
Jul 30I wouldn't ask the doc his opinion, I'd just roll that patient to the ER. Seems like a no brainer to me.