I work for a Hospice Continuous Care team. We spend our shifts (8-16 hrs) with one pt, and see the entire specturm of humanity: behavior, living conditions, beliefs, drama, etc. Today was a first for me. The pt (primary dx liver CA, c mets to bone and brain) is experiencing reduced urinary output, a common sign of decline. The family wants to know, "where is the fluid going? His intake far exceeds output." We (nurses over several shifts) have explained respirations, cellular functions, perspiration, and the usual and customary "shutting down" of the kidneys. Their first response is, "There's something wrong with the urinary catheter." (New cath, no distention, no bladder CA involvement, no blood in urine.) We explain s/s of retention, etc. The family has asked these questions every shift for the past three days.
Today, during what has become a usual and customary dialogue, the PCG says, "What about dialysis, you know, like for people with diabetes whose kidneys don't function properly? I have a friend whose husband had a portable dialysis machine, and they even traveled!" The patient's BP is 80/48, he's eaten up c CA, and she's talking about dialysis and travelling. It was all I could do to keep a straight face.
I just had to share. This was too strange to keep to myself.
