Published Jan 25, 2009
mawlvn
23 Posts
Our MDs are becoming increasingly cautious of ordering IV contrast on pts with marginally elevated creatinine levels. We are guided more often by the GFR. This is presenting problems with the consequence of infusing 500 to 1000cc of IV NS in an outpatient setting. Some, who do not give good histories have become overloaded. This adds another responsibility to an area that is supposed to be free flowwing and with rapid turn over. It is wrecking havock with our schedule. We are all being so very cautious of the patient response.
Is anyone else being faced with this?
Radnurse54
69 Posts
Our hospital has been requesting attending staff to give instructions to patients with borderline GFR's to do po hydration prior to the exam. The patient is to drink 2 liters of fluid over the 12 hours prior to the exam.
For some patients we do give IV fluids 1 hr prior and 2 hours post CT. This is by weight and taking into consideration dialysis/CHF etc issues.
Yes, it can tie up space, however, we put them on a rolling IV pole with their pump and sit them in the lobby next to the CT area, where we have LPN's who do the IV starts for CT and MRI nearby. The CT staff is able to DC their IV's when completed if necessary.
Kristej
12 Posts
Having the same problem and it is really screwing up our schedule. A common CTA is now being hydrated and taking up space and time we just don't have. I have an issue with techs starting the IV fluids, putting the patient in the hallway with a wide open IV running and then moving on to the next patient. Just don't think this is safe.
Guess I'm not the only one with a hydration issue.