pt. suspected drug user

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If a patient comes in to the hospital for an OB check with heart rate in 115-120's consistently, do you need the patient's consent to send urine sample for tox screen? Pt was scared and complaining of ABD pain. OB patients always give sample every visit to dip anyway so can you just tell them after they give you a sample that you're going to send it to the lab for a tox screen and U/A? As an OB nurse, what would you do in this situation. I'm a student. Thanks.

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Specializes in OB L&D Mother/Baby.

If I provide the assessment to the doc and they order a tox screen we run it without the knowledge of the pt.

Many times if we do get someone who is a user they will ask "why do you need my urine" when you ask for a sample... I mean we get them on everyone for a ua but the people that seem to know they will drop dirty get offended at the prospect of giving a sample.

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If I provide the assessment to the doc and they order a tox screen we run it without the knowledge of the pt.

Many times if we do get someone who is a user they will ask "why do you need my urine" when you ask for a sample... I mean we get them on everyone for a ua but the people that seem to know they will drop dirty get offended at the prospect of giving a sample.

what would you do if they expressly forbid you from doing a tox screen?

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Specializes in med-surg.
If I provide the assessment to the doc and they order a tox screen we run it without the knowledge of the pt.

Many times if we do get someone who is a user they will ask "why do you need my urine" when you ask for a sample... I mean we get them on everyone for a ua but the people that seem to know they will drop dirty get offended at the prospect of giving a sample.

www.allnurses.com is not as private as you think.

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www.allnurses.com is not as private as you think.

it isnt private at all....so what is your point?

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Specializes in OB.

Check with your docs - some practioners have permit to do drug screen and other labs as part of their general consent for prenatal care for all their patients - signed when the pt. initiates care with the provider, or the admission consent may be worded to cover tests deemed necessary by the practioner. In that case just obtain the specimen and send it. If the patient refuses accept that but note exactly what the patient says in charting the fact. The infant should then be screened after birth for the presence of drugs (can be done on mecomium).

If a patient asks, I tell her what we are testing for. I also ask her what drugs she has been using, telling her that I don't really care what she's been doing as a moral issue, but want to be prepared to treat her infant for the withdrawal symptoms it will experience some hours/days after birth. Surprisingly, some women are actually honest about it at this point. (Had one who said "Just read the list and I'll tell you which ones I haven't done".

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Specializes in OB.

By the way, looking at the ads at the bottom of this thread - is it really appropriate on a board like this to have all these ads for "beating" drug screens?

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Specializes in OB L&D Mother/Baby.
By the way, looking at the ads at the bottom of this thread - is it really appropriate on a board like this to have all these ads for "beating" drug screens?

I have a different ad on the bottom of my screen but that is interesting isn't it??

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"Just read the list and I'll tell you which ones I haven't done".

Ok...this is pathetic...and funny as all get out at the same time.:rotfl::rotfl:

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By the way, looking at the ads at the bottom of this thread - is it really appropriate on a board like this to have all these ads for "beating" drug screens?

The ads at the bottom of the screen are auto-generated based on keywords detected in the text of the original post and the replies. I too have an ad about beating a drug test a the bottom of my screen.

A lot of websites are set up like this and I don't think Allnurses has any control over the individual ads that pop up.

As to the original post, drug testing was part of the treatment consent. It was also part of our prenatal clinic's treatment consent so most of the women who were going to test positive had already tested positive in the clinic.

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Specializes in Emergency.
what would you do if they expressly forbid you from doing a tox screen?

In this case probably tell them they would be signing out AMA from our facility and that our doctors would not be caring for her. The she is not the physician and she does not tell them how to practice medicine.

Rj

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From reading the post, it seems like you think the pt is a drug user just because her HR was 115-120. If I was scared and in pain, I think my heart rate would be slightly increased also.

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