Soulwindow42

Its alright maam, ur welcome, and tnx too.

Certainly u did the right thing and its simple. Why give more if the pt has more than enough. It would be safe and protective for you and the doctor if you have called him again, or call your charge nurse for help to talk with the doctor. He may get irritated but he will realized he should be grateful you prevented the patient from possible cardiac arrest:)

you have done things appropriately. This is a case management issue and i would agree that the doctor must have seen the pt. immediately. The patient is in impending respiratory failure probably secondary to CHF with Acute pulmonary edema.(Does the chest xray shows it?). At that time, giving of high dose lasix immediately might have a big impact on the succeeding management of this pt, together with biPAP. Your MD is well-informed enough that it will only take approx. 5-10 minutes of hypoxemia and you will developed encephalopathy, which might lead to irreversible coma. The patient should been admitted to critical care/Intensive care unit in the first place and aggressive monitoring and management should have been done earlier. If you think you are right, trust ur instinct and be assertive in a nice way. If not, always call your immediate supervisor and superior if this happens again. tnx

You have just done a good job to the best of your knowledge at that time, and you have greatly avoided a possible surgical post-operative morbidity (another Fracture or prosthesis dislocation should the patient falls down). However, this patient has dementia and can't comprehend all what you will say. There is a possibility he might stand up again and take most of your time for attention. Hoyer lift is good, but I don't conform with them having u written up. What is important is nothing worrisome happen to the patient. Keep up the good work.