Rocker

Hey guys, I just wanted to get your opinion on a scenario I experienced tonight at work. I'm sure you work with many confused pts so I'd appreciate your insight. I'm a CNA/nursing student and tonight I was caring for a 70/M 2nd-day post op total knee replacement pt with acute confusion (no hx of confusion/dementia). He was alert but not oriented. He was having visual hallucinations of animals and of his family members. The staff suspected his confusion was due to Percocet, but the house Dr ordered a urinalysis/culture as well (results are still pending). His mobility was shaky and required a walker with an assist of one. VS 98.4 108 20 113/78 O2sat=94% Now that you have his background, I wonder how you guys would respond to some situations I faced with him... He constantly wanted to get up and "go home" or "leave this hotel". The staff and I ambulated him in the halls often. Everytime he ambulated he would get tired and want to go back to bed. This intervention seemed to be working to keep him calm, but then he started trying to leave the floor and became agitated when we stopped him. He basically got agitated whenever we told him 'no'. I can't imagine any nurse spending all their time with this Pt and getting anything done.. Question #1: is it better to ambulate the pt any time he wants to get up? or sit in the room and ask him to stay in bed (and cause agitation)? Question #2: is it a good idea to hand him his cell phone so he can call someone to "come over" and "pick him up"? (Part of me says he has a right to call his family, but then another part of me thinks that I'd have to explain to the people on the phone the situation and possibly cause unnecessary fear and worry about their loved one). Question #3: should we let him refuse his sedative/antipsychotic or is it okay to 'persuade' him into taking a sedative/antipsychotic by saying things like "this will calm your nerves, this will help you sleep/feel better"? Lemme know what you think.. I appreciate your help :)

hey rmkelly, thanks for nothing. if you don't like the topics, tough. if you're going to be negative, we don't want you here. find something better to do than hating on other ppl

got it. thanks a lot everyone:yeah:

Hi, so I'm a nursing student+CNA at a small town hospital and tonight I encountered a Pt (former RN) who told me I shouldn't do her BP on her right arm because there was a medlock that forearm (appeared to be in the basilic vein). Now there were no fluids running, no hx of masectomy, and no neon-braclet to indicate I couldn't do a BP. I didn't follow her logic, but I just shrugged and switched the BP cuff to the other arm. I wanted to question her, but her family members were there and I didn't wanna embarrass her. SO 1) is a BP contraindicated on an arm with a medlock and no fluids running? 2) is a BP contraindicated on an arm with a medlock with fluids running? 3) is this woman a whack job?