Published Jun 5, 2016
Twinmom06, ASN, APN
1,171 Posts
we have several FF at the hospital I'm assigned to 95% of the time. #1 reason they come in? Skip a weeks worth of treatments and come in SOB with a K of 7 or better, and then leave AMA once treated... Best part is they come in to the hospital ON THEIR TREATMENT DAY!!! Please, just go to your clinic, have the weight taken off and go on with your life.
/rant and sarcasm off.
NurseRies, BSN, RN
473 Posts
In my area, if patient miss a week of treatment or even 2 treatments, then show up at clinic, some clinics will send them to the hospital because they do not know their current state of health. Sure enough they'll show up with EKG changes and a K of 7.4.... It's frustrating but that's acutes and it will always be acutes!!! Eventually the FF pass away... Seen it time and time again, it's usually the young ones.
oh I know...its just ridiculous - if they just kept their appts and went to them there wouldn't be this issue...I was just ranting because Saturday was one 4 hour and one 2 hour treatment and I should have been home by 330 instead of 10 because we had one skip her tx on Saturday because she couldn't get out of bed to make it, and then call EMS to come to the ER. We also think she has K pills in her purse because we'll dialyze her on a Tuesday and by Thursday her K is in the 7s again when she's inpatient. She was also caught in the pantry on the floor she was admitted to drinking multiple cups of OJ and eating PB packets...
Oh my... I hear you. I have seen those patient who continually have high K while in the hospital. I think some of them cheat on their diets, but others of them I believe have some major problems with glucose control. It's usually the brittle diabetes where we can't control their K, also could it be an access issue or poor clearance for some reason? The persistent high K cases amaze me!
Chisca, RN
745 Posts
Shouldn't repeated suicide attempts require psychiatric intervention?
one of our nephrologists actually DID a psych consult on a guy that would skip weeks of treatment and then come to the ER!
Had another one last night keep me there until 10 pm because of missed treatments, Hgb of 6.4, K of 7.7 and 15 kg over dry...he claims he only missed 2 treatments, my thought is that he hasn't had tx since 5/26 when we discharged him last time.