Pt is septic, so let's dc all IVF

Nurses General Nursing

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SBP starts decreases from 110 to around 98, and urine output decreases from around 50 down to 25, but the resident and even the attending don't want to start IVF. What are these people thinking????

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

Renal Failure? Fluid Overload?

What's the CRX say? The BNP? BUN/CR?

I agree though, sounds like some IVFs might be in order.

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Is Hospice at the bedside?

-R

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Specializes in MS Home Health.

Bring in the stat cart....

renerian

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Yikes! What was their rational? A CHF patient? How is the patient now?

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Specializes in Hemodialysis, Home Health.

Did you ASK them why not?

I always ask.. don't care how dumb I make myself look. If something bugs me or I don't understand why they do or don't do sth., I just HAVE to know WHY. I don't care WHO they are... I ask.

So...... WHY ? :D

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Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.

I'm with Jnette- why aren't you asking them? Have you read the progress notes? I also agree with 3rdshiftguy- what do the CXR and labs say? What are the pt's lungs sounding like? Has the pt been placed on Heparin? If so, that could explain the drop in SBP. If the UOP was already down to 50 with IVFs, you could assume ARF, but I would check the BUN/Creatinine, too.

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Specializes in Interventional Pain Mgmt NP; Prior ICU and L/D RN.

I agree I would be asking the question of WHY???

Also; what else is going on with the pt that may prohibit starting IVF's????

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Specializes in Hemodialysis, Home Health.

OK... now we're all curious. See what you started? :p

So go find out what all is going on with this patient, the diagnosis and/or rationales behind the decisions to hold IVFs ( I think we all have some ideas on it).... and get back to us! Now you have to persue this, see, 'cuz WE WANNA KNOW!!! :D

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Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.
Originally posted by jnette

OK... now we're all curious. See what you started? :p

So go find out what all is going on with this patient, the diagnosis and/or rationales behind the decisions to hold IVFs ( I think we all have some ideas on it).... and get back to us! Now you have to persue this, see, 'cuz WE WANNA KNOW!!! :D

:chuckle :chuckle :roll I wanna know, too!!!:)
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Specializes in LTC, assisted living, med-surg, psych.

Here are a couple of unsavory thoughts I can't help wondering about: How old is the pt, and what's their code status?

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Originally posted by mjlrn97

Here are a couple of unsavory thoughts I can't help wondering about: How old is the pt, and what's their code status?

MY thoughts exactly! I'm thinking of the time I started IV hydration on a client who had terminal CA. The doc. called the wife in the middle of the night to tell her to turn the pump off, because tests had showed he was in total renal failure.

He died later the next day.

It was one of those times you could kick yourself for carrying out the doctor's orders, but aside from the lack of urine output, there were no other warning signs. He was definitely dehydrated, though, so that would have masked it.

And I'm NOT a fan of giving IV fluids to terminal patients (gee, wonder why?? :rolleyes: ) but that's a whole 'nother thread!

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