Is This Possible??

[mrscoozy]

so i worked the night shift last night and one of my pts was a forty something female...hx of htn, new onset iddm, obestiy, and all sorts of other problems. anyway when i weighed her in the morning she had a wt gain of almost 27 pounds from the day before. believe me i weighed her several times on different scales. they were all relatively the same. has anyone ever heard of such a wt gain in one day?? is it possible??

[KneKno]

Maybe the initial weight was wrong?

[tatara]

hmm...are you sure her recorded weight in the previous days were taken accurately using the same weighing scale each time and at the same period of time, say 6am eveyday?

27 lbs is quite impossible to gain in just 24 hours unless your patient is massively retaining fluid, and IVF and oral fluid intake is increased. She should appear really bloated and has scanty urine output.

Is she wearing a leather coat and metal accessories? Silly me.

[TheCommuter, BSN, RN]

Some admission nurses obtain their patient weights the lazy way, which is by simply asking the patient, "How much do you weigh?"

Of course, many patients love to underestimate how much they weigh, because it can be a potentially embarrassing issue to discuss. This "stated weight" is documented on the initial assessment, which may cause future problems for any care providers who come along and try to compare this "baseline weight" to any actual weights obtained during the course of the hospital stay.

Unless your patient is displaying gross signs and symptoms of fluid overload, I would suspect that the previous weight was pencil-whipped in an effort to save time.

[mrscoozy]

Lol...I understand the confusion. We weigh out pts in their bed...so yes it was the same scale and the 4 previous days she had been there her wt was documented at around 27 lbs lighter. I even weighed her on a different scale. She was pretty bloated and had some pitting edema, but not 27 lbs worth. It was just weird. The Doc looked at me like I was crazy in the morning when I told him...but he did order lasix.

[mamamerlee, LPN]

You would know a 6-8 lb weight gain. There must have been SOMETHING wrong with one ogf the weghts.

[tatara]

Lol...I understand the confusion. We weigh out pts in their bed...so yes it was the same scale and the 4 previous days she had been there her wt was documented at around 27 lbs lighter. I even weighed her on a different scale. She was pretty bloated and had some pitting edema, but not 27 lbs worth. It was just weird. The Doc looked at me like I was crazy in the morning when I told him...but he did order lasix.

:chuckle I can imagine how he looked at you.

That's over 12 kilos, meaning over 12 liters of fluid retention if ever!? The patient must have that loose and large skin surface area which can accommodate that amount of gain and not showing the expected significant signs of fluid overload.

Even Spongebob can't be that absorbent (Kidding). Here I am again, crazy as ever

[TheCommuter, BSN, RN]

Lol...I understand the confusion. We weigh out pts in their bed...so yes it was the same scale and the 4 previous days she had been there her wt was documented at around 27 lbs lighter.

This might be sad to say, but maybe the nurses had been pencil-whipping the weights over the past 4 days. Perhaps you're the first person who has come along to attempt to weigh her properly, even if the patients are being weighed in bed.

Sorry, but the paranoia is oozing from the crevices of my brain.

[PICNICRN, BSN, RN]

Mostly all of our pts are weighed in bed also, one thing that I have learned to do is when I do the initial weight is to put a note taped to the bed that says- "pt weighed with crib sheet, X amount blankets, leads, vent tubing, ect"- whatever the case may be so that the next person knows what to zero the bed with or at least they have some idea of what the last person has done.

[tewdles, RN]

**still chuckling about "pencil whipped" weights**

[HeartsOpenWide, RN]

anasarca?

[PICNICRN, BSN, RN]

Off topic>>>>>> I wish I could loose 27 lbs in 4 days!!!