Received a patient who was diagnosed with N/V and PNA. White count and platelet count are critically elevated. She has a hx of esophageal cancer and is currently on chemotherapy.When I did the TB risk screen, she states present problems of cough > 1 wk, fever/chills, hemoptysis and unexplained wt loss. So immediately notified the MD and transferred her in a negative pressure room to r/o TB.However, I'm not sure if I did the right thing? Due to the fact that this pt already has esophageal cancer and getting chemo tx... so symptoms are probably from this?Before admission, ER doc performed a CXR and saw infiltrates either in the RML or RLL.Any feedback would be appreciated.
allnurses Guide Nurse SMS, MSN, RN 2 Articles; 6,837 Posts Specializes in Critical Care; Cardiac; Professional Development. Has 12 years experience. Sep 23, 2013 The downside of being wrong is less disturbing than the downside of not isolating the patient and should have. If you had suspicions it was appropriate. If you are wrong the patient can be moved back out again, right? I don't see this as being even remotely worth fretting over.
Long Term Care Columnist / Guide VivaLasViejas, ASN, RN 142 Articles; 9,981 Posts Specializes in LTC, assisted living, med-surg, psych. Has 26 years experience. Sep 23, 2013 I concur.
0.adamantite 233 Posts Specializes in Acute Care - Adult, Med Surg, Neuro. Has 3 years experience. Sep 23, 2013 I had a similar experience with a patient. The supervisor was mad we had to move the patient but then the patient coughed up a bloody lougie and I believe later on the TB was confirmed. Learned from the ID doctors in immunocompromised patients TB tests have a high false negative, as well.
ak2190 94 Posts Specializes in ICU, Geriatrics, Float Pool. Sep 23, 2013 It can't do her much harm and could possibly benefit her so... no you're fine.
Esme12, ASN, BSN, RN 4 Articles; 20,908 Posts Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 43 years experience. Sep 23, 2013 If you are wrong there is no harm to the patient and bedsides I'd rather have a private room....If you were right and didn't move her it could be harmful to many.I think it was a prudent move.
