Lame admit Dx's - page 4
Ever wonder how/why some can even be admitted? Maybe it's a small hosptial thing? One of our Docs admitted an old guy with: Fear of back pain. Does insurance even reimburse for that??... Read More
May 13, '02I think the exhaustion excuse covers psych admissions. They always come after someone was seen acting bizarre. And don't forget dehydrated. The celebrities are always exhausted and dehydrated.
That's what makes them do those crazy things!
May 14, '02there are icd-9 codes for some of these. these came from international classification of diseases 9th revision, clinical modifications, 2002 edition, printed by the ama press.
failure to thrive, adult - 783.7
status asthmaticus - 493.9
syncope (near) - (pre) - 780.2
abdominal pain - 788.0
cephalgia - 784.0
intractable vertigo - 780.4
change in mental status - 780.9
chest pain - 786.50 through 786.59
we had one last night, 101 years old. "inability to ambulate". icd-9 for that? lol! :chuckle
May 14, '02I'm not surprised at all by that. Inductions for ladies tired of being pregnant and for daddy's scheduling convenience, happens all the time.
Lame, yes. But not surprising.
I hear ya. A friend of mine has an older sister (who IS an OB/GYN MD, for the love of God) who recently had a baby. She decided that, instead of waiting for labor or heck, even sucking in some Pitocin to induce, she was just going to schedule a C-section.
Mmhmm. She picked her kid's birthday - conveniently situated within her schedule - and went in for the cut.
I made my friend repeat himself at least three times before I believed his sister was doing that... ::shakes head::
May 16, '02I work on a locked adult psych unit. One of the local nursing homes is notorious for dumping their more challenging patients on us. The latest: rule out altered mental status. The patient was 72, MMR, had COPD and CHF. We ended up providing respite care for the nursing home staff!!
May 16, '02Originally posted by caroladybelle
I also had an admission for "Tired x 2 weeks"
So when do we all head to the hospital!!!
May 16, '02yeah...........i was kinda thinking about calling 911, because i was tired.
however.............i fell asleep! :chuckle
i feel pretty good now! lol!
May 16, '02Near syncope-what is that, I thought I was going to pass out/fall, but i didn't.
Unresponsiveness to ICU-had a blood alcohol of 498,DUH!!!
AMS in pt's who are already demented or have Alzheimer's--how
would you know?????
How about triage complaints:
"my penus has tairs in the 4skin"
"I'm out of my Oxycontin"
"Someone broke in my hotel room, took only my Soma, Valium and Hydrocodone(not mind you any cash,credit cards, or jewelry)"
Chest pain in 18 yo female with no medical or family history.:roll
May 16, '02I worked for several years on a mat/gyne unit. We used to get "Squirrely Shirley" admitted by her GP for "hyperemesis gravidarum". Shirley had no weight loss and no emesis, but we would have to start an IV on her.
She always started out in a 4 bed ward, but would 1) sleep all day and be awake all night, talking on the telephone, reading, ordering in pizza (!), 2) showering at all hours of the night, and 3) passing wind, if you know what I mean. Eventually her roomates couldn't stand her anymore and they would ask to have her moved to a private room, which is EXACTLY what Shirley had wanted to begin with.
One night, a friend of mine heard the shower running in Shirley's 4 bed ward. Dorothy opened the door and saw Shirley, lying on her back in the shower, legs up against the wall, sound asleep.
When her husband would visit, he would bring her flowers and "real food" from an expensive restaurant. Her "hyperemesis" would clear up and she would get discharged home. Several weeks later, she would be admitted again. This went on right through 3 pregnancies.
Finally, I had the "bed utilization" doc confront Squirrely Shirley's GP, who admitted that he would admit her for HG when she have a fight with her husband (!!!). The bed utilization doc told him that this was an acute care hospital not a social services agency. Fortunately, Shirley had her tubes tied after her 3rd baby.
May 16, '02Many years ago, I thought that I might try my hand at psych nursing. One night shift, I had to admit a late - 40s woman, committed by her GP. Her diagnosis: inability to sleep all night, hot flashes, irritability. I said, do you still have your periods? "Once in a while". After I finished admitting her, I said to the charge nurse "it sounds to me as if this lady needs a D&C and put on hormones. I'd say that she was menopausal". "Oh no" said the charge nurse, "menopause is a psychiatric condition according to the DSM". When I came to work the next night, the woman had gone to the OR for a D&C and then gone home with a prescription for HRT. So, is the DSM written by men?
May 16, '02Well, not long after graduation, I was working in a small community hospital-kind of a satellite unit to a larger facility and I noticed there were quite a few people coming in with the diagnosis of situational anxiety to pregnancy....Had no idea until a more seasoned nurse mentioned that was the code for abortion....Then we have threatened vs r/o spontaneous abortion...Hello??? And, even while doing critical care I did always have to chuckle at near syncope...We are ALL near syncope....