Lame admit Dx's - page 6

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

  1. by   PediRN
    NICU...severe immaturity
  2. by   tropw
    how bout an alert and oriented little old lady admitted with the vapors and giggling
  3. by   talaxandra
    My favourite of all time is "walklessness for investigation" - new resident who forgot the word ataxia!
  4. by   CseMgr1
    Look that one up, in your ICD-9 Codebook...What a hoot!
  5. by   okihusker
    I am a military nures in Japan. Another good lame admission dx, that I seen by our stellar physicians (NOT!) was: a Marine that went out to dinner for sushi. After he stuffed himself with sushi and proceeded to drive back to camp, he remebered that his mother told him he had an allergic reaction reation to fish when he was very young. So he went to the local military ER and checked himself in -just to see if he should take something. With no sysmptoms, they gave him 125 mg of Solumedrol IV, 50 mg of Benadryl IV, 50 mg of Zantac IV, and started him on a epi gtt at 2.5 mcg. The ER doc then sent him up to the ICU for the Internest to admit him for an Airway Watch, Anaphylaxis Prophylaxis. The Marine had a BP of 200s/100s and a HR of 160s (from the epi of course). He said he felt so much better before he came in to the hospital. Needless the say, when the Internest came in, he was so pissed. He d/c'd everything and sent him back to duty 8 hours later.
  6. by   sleepqd
    One of our local nursing homes sends over patients with"altered mental status" .How can a mental status alter when the resident has been unresponsive for years? Looks to me like any alteration would have to be an improvement.

    We have had one women admitted for "eructation and flatulence". I think the doc needs to check his codes!!
  7. by   RN-PA
    Yeah, we get a lot of "change in mental status", too, where you kind of say, "how can you tell?"

    Within the last month, I had a patient in his 30's admitted with "Pharyngitis". Sheesh... I get pharyngitis every year or so and I realize airway problems can be a potential concern, but this guy looked healthier than me! I was thankful for him, though, since he was my easiest patient that night.
  8. by   l.rae
    50 yr old female w/ no hx...23 obs on tele..dx=numbness of lower lip, throat burning assc. w/chest tightness. pt smokes, has been on ativan long term but has been out of vitamine a for about 5 days..felt a lot better after an im dose was given. duh lr
  9. by   mercykitten
    At my hospital, we consider "near syncope" as pt falls, or maybe comes close to falling but never actually loses consciousness.

    Last week we got a transfer from oncology. The diagnosis resulting in the transfer "dehydration." So I asked, "can't oncology treat pt for dehydration?" We still got the pt, who it turned out was having a lot of diarrhea stools and took at least two people to clean up with these frequent incont. stools.
    Also, we get a lot of admissions from ER, where the diagnosis is one that if WE (hospital employees with the hospital' insurance) showed up in ER, we were get sent home....definitely not admitted (because the hospital would lose money).
  10. by   Mietze
    I just completed a travel assignment working on Peds. Come Friday afternoon the admissions would pour in. All good, however most of the patients were admitted because it was getting close to 5PM on a Friday and the physicians didn't want to stay over. So it was easier to admit and get them off their hands than to deal with the problem. Now granted, some of the admissions were medically necessary.
    I Dr. ever get labeled as lazy? Go figure!
  11. by   SmBaxter
    My personal favorite bad dx is CHANGE IN MENTAL STATUS...then they always turn out to be a&ox3-just really weird!
  12. by   whipping girl in 07
    Sunday night I was "tasking" in ICU (the nurse there for admissions, we always have to have admitability for two pts at the beginning of the shift). Call me crazy but I love to get admissions. You just never know what's going to roll through the door.

    Nsg supr calls and says we might get a pt from post-op; no BP, no UO, temp 94 on a bear hugger! Pt's doc happens to be rounding in ICU (pt had been in ICU and I had taken care of him about 10 days before) so I told him about the pt. He said, "Sounds like he's dry to me," which I agreed with based on what I'd been told on the phone.

    Nsg supr calls back and says we're not getting pt; then MD calls and tells me he's going to transfer pt to ICU out of pity for the nurse caring for him. "Poor thing, she can't stay in there all night, she has too many other pts and I'm ordering blood for him." He then proceeds to give me the pt's orders and then says, "Use your judgement on verbal orders from me; do what you think you need to do."

    Got the pt, LR bolus infusing, lungs sound wet and congested, so we snogged him (I hate doing that to a conscious pt!!) and started blood. After two units and lots of fluid, pressure still 60s-70s, no UO, temp up to a whopping 95. But in the midst of all this drama, I got another admit, pt with pressure 210/120, tachy, confused, completely out of the box, probably DTs! I spent an hour never leaving the second pt's room (titrating Tridil, pushing Ativan and trying to keep him in the bed), and another hr taking him to CT (a CYA order if I ever saw one). Now granted, pt #1 was on a monitored bed, but we weren't aggressively treating the BP (no gtts) and the doc was going to talk to the son about making pt DNR in the AM.

    Now I've floated to post op before, and most of the pts are basically self care. It went against my normal habits to not be bouncing in all the time waking them up, checking pulses and vitals. I've seen this particular nurse work, as she's on the same weekends I am (or maybe she's weekend option or something). We get a pt from her every time I work, and she literally runs the whole time she's working, while everyone else seems to have an easy night. They staff by acuity, so I know she's not just getting shyt on.

    I guess what I'm getting at is the pt didn't get any better care in ICU than he would have on the floor, as my other pt was out of the box and I was off the unit and some of the other pts were keeping us pretty busy too. I know we have less pts per nurse, but our acuity is so much higher. The pt didn't belong in ICU, but the MD put him there to give the nurse a break?! Now granted, after the fluid bolus and the blood didn't raise the pressure or get some urine going, then I could see transferring him. But I guess the doc was saving himself from getting awakened by this nurse.

    Any comments?
  13. by   dawngloves
    Originally posted by konnihall

    Any comments?
    Yeah dude, what the heck is snogged???!!!