DNR

[thisnurse123]

This has probably been asked before.

Fake scenario:

Patient has frequent UTI’s and starts to wheeze. Has been hospitalized for a similar incident one month prior. The provider RN on call says to send them out. The POA refused. The patient was sent out anyway. Is this usual?

[thisnurse123]

3 hours ago, Lunah said:

Never had this fake scenario before? ?

Hah LTC is the wild Wild West. It happens.

[BostonFNP, APRN]

On 11/26/2022 at 9:19 PM, thisnurse123 said:

This has probably been asked before.

Fake scenario:

Patient has frequent UTI’s and starts to wheeze. Has been hospitalized for a similar incident one month prior. The provider RN on call says to send them out. The POA refused. The patient was sent out anyway. Is this usual?

Unusual for wheezing to be a symptom of recurrent UTI? ?

[offlabel]

1 hour ago, BostonFNP said:

Unusual for wheezing to be a symptom of recurrent UTI? ?

hah...yeah...until the UTI migrates to the lungs?

[thisnurse123]

20 hours ago, BostonFNP said:

Unusual for wheezing to be a symptom of recurrent UTI? ?

Haha yeah urosepsis which isn’t funny? but hard to prevent in elderly https://www.thoracic.org/professionals/clinical-resources/quick-hits/dyspnea-and-recurrent-urinary-tract-infections.php

19 hours ago, offlabel said:

hah...yeah...until the UTI migrates to the lungs?

Made my noodle think ? https://www.news-medical.net/amp/news/20131009/Asthma-infection-risk-goes-beyond-the-airways.aspx

[BostonFNP, APRN]

3 hours ago, thisnurse123 said:

Haha yeah urosepsis which isn’t funny? but hard to prevent in elderly https://www.thoracic.org/professionals/clinical-resources/quick-hits/dyspnea-and-recurrent-urinary-tract-infections.php

Made my noodle think ? https://www.news-medical.net/amp/news/20131009/Asthma-infection-risk-goes-beyond-the-airways.aspx

Ahh but that Macrobid induced ILD had clear lungs to auscultation (though clinically you'd expect to hear the dry crackles I'd think). ?

[thisnurse123]

52 minutes ago, BostonFNP said:

Ahh but that Macrobid induced ILD had clear lungs to auscultation (though clinically you'd expect to hear the dry crackles I'd think). ?

Thanks for teaching :) hopefully another student will find this useful as well and not assume crackles are from the eldery being mostly bed bound :) This feedback defintitely helped me think deeper about the patient.

[NRSKarenRN, BSN, RN]

Thanks for the above links.  Son with 175 kidney stones, recent UTI's treated with Macrobid, chronic cough this year, nonsmoker.  DX Asthma in Spring.  Had CXR + PFT normal . Will send article to him to discuss with Pulmonologist.

Always learning something new here.

[BostonFNP, APRN]

45 minutes ago, NRSKarenRN said:

Thanks for the above links.  Son with 175 kidney stones, recent UTI's treated with Macrobid, chronic cough this year, nonsmoker.  DX Asthma in Spring.  Had CXR + PFT normal . Will send article to him to discuss with Pulmonologist.

Always learning something new here.

Interesting. Macrobid is a strange call for a male with UTIs especially if associated with kidney stones. Listen to his lungs, see if he has a Velcro sound on inspiration, those sharp powerful crackles are a hallmark of ILD/IPF.