Question about "terminal diagnosis"

  1. Just signed up a patient yesterday, in her late 60's, chairbound. she has had numerous surgeries, including a massive infection to her hip and femur (therefore she has no hip or femur). other ankle has had many surgeries, is unable to stand, has to use a hoyer lift. she has heart failure, etc.

    i got a script from her Md to evaluate and treat, but he didn't give me a "terminal" diagnosis.

    what do you all think.

    thank you! i'm still learning

    linda
    •  
  2. 6 Comments

  3. by   tencat
    Wow, it's one of those 'pick a diagnosis' patients that have so many co-morbidities that any one of them might kill the patient. I saw heart failure in your list. Might that be the 'one' terminal diagnosis?
  4. by   AtlantaRN
    Quote from tencat
    Wow, it's one of those 'pick a diagnosis' patients that have so many co-morbidities that any one of them might kill the patient. I saw heart failure in your list. Might that be the 'one' terminal diagnosis?

    yes, heart failure should do it.

    Actually, I was at the assisted living facility to sign up her hubby who has end stage copd...she brought out a list of her meds and her surgeries and she asked if I would call her doctor -which I did-and he faxed over an order.

    yea! a two-fer... makes visits easy.......

    linda
  5. by   kyhospicenurse
    I would go with CHF especially if you can get documentation supporting it.
  6. by   introspectiveRN
    I usually choose the dx that will allow me to provide the most meds. Usually this is CHF, COPD or ES CAD....with Adult FTT there are more meds that could also fall under this, you just have to make certain that your diagnosis requirements are met. And, if you are going to keep at FTT they can only gain a little weight and their BMI must stay below 22.Good luck to you in your learning.
  7. by   kyhospicenurse
    I'm a little leery of adult FTT. I think it is used way too much just to get a person in hospice when in fact there are much better substantiated diagnosis that fit the pt. We had a little guy in our program for FTT. He couldnt stand the nursing home's food so he didnt eat much. To make a long story short, we ended up changing his diagnosis to ES COPD which it should have been in the first place in order to not have to discharge the guy. He had many co-morbids. He no longer fit in FTT after I started taking lunch to him a time or 2 a week and he gained several pounds and BMI went greater than 22 :-)
  8. by   AtlantaRN
    she can't be failure to thrive because she is in the upper 200 range, if memory serves, and she is 5'11"

    i'll go with CHF.

    thanks for all you input.

close