jlynn3324

I have a patient that has CHF and was recently in hospital for CHF exacerbation and pneumonia. While in hosptial she had a Thoracentesis. I received a call from her sister today who wanted to know why this patient was on so many medications (Lasix, Aldactone, Coreg, Lanoxin, Potassium, etc). I tried to explain all medications, what they do and the importance of taking daily as ordered. The sister stated she used to be a nurse and patient was taking too many medications. Sister stated she told patient not to take medications today. The patient has a little confusion but is fairly competent. I tried again to educate on importance of taking these medications to prevent exacerbations but this did not help. I finally told sister to make an apt with MD to discuss the medications.This patient has been non-compliance in the past and on many occasions the nurse has noted +3 edema to bilateral ankles and crackles in lung fields. I informed the MD of my conversation with the sister and nurse stated she would make note and inform MD. I also told nurse that sister will be calling to make apt. I tried calling this patient's daughter but no answer. What else can I do? A nurse is going back out tomorrow to talk to the patient face to face. I have also given patient written info about medications. Any sugestions? :banghead:

I am new to the site. Hello! I am a home health nurse of two years and am currently taking care of a chemo patient. She is getting continuous TPN through her mediport. We change the huber needle weekly and draw lab's at that time. I have accessed approx. 20 mediports and have been the only one to access this patients mediport since she started TPN around June 1st. Yesterday I replaced her huber needle, as usual, using a 22G 3/4 huber in the exact same place it was accessed previously. I also obtained lab as follows: I flushed port with 10 cc NS, then aspirated 10cc of waste blood and threw away and then aspirated another 10cc for my lab. I then flushed with another 10cc followed by heparin. I then hooked this patient back up to TPN and when I left all was fine. I get the lab back from the hospital and her WBC was 1.4 and platelet is 6. I call MD who has patient come to hosptial for platelets the next day (on regurally scheduled chemo day). I get a call from the family today saying the MD drew lab again today and the above levels were normal. MD stated that I had put the huber needle in the subclavian cavity and drew the labs from there and that was why the labs were not normal. I do not understand this because, I KNOW I accessed in the same place as previous accessed and the port flused easily with good blood return. How could I have got approx 20cc of blood if I went into the subclavian cavity? I have accessed this port many times with no problems. I am really afraid to access this port again and really upset. Please help!

I am new to the site. Hello! I am a home health nurse of two years and am currently taking care of a chemo patient. She is getting continuous TPN through her mediport. We change the huber needle weekly and draw lab's at that time. I have accessed approx. 20 mediports and have been the only one to access this patients mediport since she started TPN around June 1st. Yesterday I replaced her huber needle, as usual, using a 22G 3/4 huber in the exact same place it was accessed previously. I also obtained lab as follows: I flushed port with 10 cc NS, then aspirated 10cc of waste blood and threw away and then aspirated another 10cc for my lab. I then flushed with another 10cc followed by heparin. I then hooked this patient back up to TPN and when I left all was fine. I get the lab back from the hospital and her WBC was 1.4 and platelet is 6. I call MD who has patient come to hosptial for platelets the next day (on regurally scheduled chemo day). I get a call from the family today saying the MD drew lab again today and the above levels were normal. MD stated that I had put the huber needle in the subclavian cavity and drew the labs from there and that was why the labs were not normal. I do not understand this because, I KNOW I accessed in the same place as previous accessed and the port flused easily with good blood return. How could I have got approx 20cc of blood if I went into the subclavian cavity? I have accessed this port many times with no problems. I am really afraid to access this port again and really upset. Please help!

I am new to the site. Hello! I am a home health nurse of two years and am currently taking care of a chemo patient. She is getting continuous TPN through her mediport. We change the huber needle weekly and draw lab's at that time. I have accessed approx. 20 mediports and have been the only one to access this patients mediport since she started TPN around June 1st. Yesterday I replaced her huber needle, as usual, using a 22G 3/4 huber in the exact same place it was accessed previously. I also obtained lab as follows: I flushed port with 10 cc NS, then aspirated 10cc of waste blood and threw away and then aspirated another 10cc for my lab. I then flushed with another 10cc followed by heparin. I then hooked this patient back up to TPN and when I left all was fine. I get the lab back from the hospital and her WBC was 1.4 and platelet is 6. I call MD who has patient come to hosptial for platelets the next day (on regurally scheduled chemo day). I get a call from the family today saying the MD drew lab again today and the above levels were normal. MD stated that I had put the huber needle in the subclavian cavity and drew the labs from there and that was why the labs were not normal. I do not understand this because, I KNOW I accessed in the same place as previous accessed and the port flused easily with good blood return. How could I have got approx 20cc of blood if I went into the subclavian cavity? I have accessed this port many times with no problems. I am really afraid to access this port again and really upset. Please help!