Here's a weird question: we were talking about ominous symptoms, like lower extremity weeping edema, that immediately tells you that there's real trouble ahead for the patient. (I just finished helping a new RN admit a pt to our SNF, and I mentioned how I hate to see such a very nice aaox3 lady with weeping legs...just never good). What other symptoms right away sets you off? Here's my short list (I've only been an LPN for three years, in a nursing home, so I am always trying to learn):
A suddenly nonscreaming screamer (especially night shift) takes the cake for me. I never thought that I would be relieved by sound of hollering or a call light.
I agree!! It's always nice when Mr. Screamer stops, but then you have to ask yourself, WHY did Mr Screamer stop? Rarely does he/she just falls asleep!!!
yep, when they say, "I won't be here tommorow," or "I think I am going to die." Listen.....cuz they usually are right! I agree with the Hospice patient or dying patient....when they perk up and start talking, drinking, eating, after not doing so for a time....not good.
Specializes in Geriatrics, Hospice, Palliative Care.
weeping legs don't automatically mean a bad outcome. Sometimes they are just so filled up with some fluid, sitting around all day in a WC the dependent legs pull the fluid...no place to go..it leaks out. Elevate and tell the doc. they prob need an adjustment on the lasix etc.
here is more to the list
speaking of death or visiting a loved one who has died
becoming more alert or sane
the "look"
vomiting blood or stool
Ah, I suppose that I mean continuing to weep after all of the above has been done; to be honest, I've rarely seen anyone leave our facility in good shape when they have weeping legs. But I'd love to know more if there is something else that I can do to help these pts!
Ugh, I forgot about blood in the stool; had a very nasty case of that last week and the pt is still at the hospital.
I appreciate all of the input. I was trying to express to the very new nurse something that took me a bit of time to fully appreciate: folks don't get sent to rehab just 'cause they need rehab for a new knee - they've got a bunch of exacerbated co-morbidities that are probably as big as the new knee, if not bigger.
leslie :-D
11,191 Posts
funny, i don't consider that an ominous sign.
i like it when these folks suddenly rally then die.
it's a nice way to go.
whenever i witness this, i do warn the families that it'll likely only be a matter of hours before they pass...
and reassure them, that eating, being a&o, even healing...is an ideal way to 'travel' from here to 'there'.:)
leslie