pt. suspected drug user

Specialties Ob/Gyn

Published

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.

Specializes in Nurse Manager, Labor and Delivery.

:yeahthat: You know, when I first read this thread..I thought the same exact thing. Is an elevated HR the only reason to suspect drugs in this case? Certainly there are many explanations for an increases HR, as the above poster mentioned. I would probably investigate more before going to the drug screen...but that is just me.

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I would HOPE a nurse would look for more obvious signs of drugs use before jumping to get a tox screen: jumping to that conclusion on hr ALONE is presumptous. What if the woman had a heart condition? Stress? Issues with BP? It could be alot of things. LOL

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Specializes in OB, M/S, HH, Medical Imaging RN.
www.allnurses.com is not as private as you think.

allnurses is private. every word is moderated and when a member posts their name, address, phone, or e-mail address it is removed from their post.

if a member chooses to devulge some bit of information about themselves such as where they work or where they currently are on vacation, etc...then they are solely to blame for that information being made public. it is no fault of the site or the moderators.

i was once referred to a different site. i went to check it out. they actually expected me to enter my state and license number to verify that i am a bonafide nurse. :no: i don't even let my employer have a copy of my license, they are only allowed to inspect it and make a note of the number.

but....what does any of this have to do with the op? just curious.

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Specializes in Community, OB, Nursery.

Just to clarify, before we get back to the regularly scheduled topic.

Allnurses is privately owned and operated. However, it IS on the world wide web for anyone who stumbles across it to read. For every registered poster, there are many many lurkers who can read anything anyone posts. We have no control over that.

On the topic of UDS - I tell my patients what I am collecting their urine for. I want them to trust me, and they won't if they feel I'm lying to them or trying to trick them. I tell them why as well.

Where I am, anyone with a hx drug use and anyone who got no prenatal care gets an automatic UDS. I tell them it's not meant to be a judgement on their character, nor are we picking on them. It's in the orders for us to do for everyone who meets those criteria. Most people are pretty forthcoming about their use.

We also bag the babies to do a UDS, and I tell mom what we are doing and why. I can only remember one instance where mom/family tried to pull any stunts, and she got caught pretty fast. She had some psych issues as well.

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

After I finished my list, she added a couple I hadn't had! Truly, when we were done, I did thank her for her honesty and told her that it would be very helpful in making sure her baby had appropriate treatment. (The broader issues could be saved for a later time).

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Specializes in OB.

With our docs, the pts. sign a form saying they consent to any and all UDS so if they come in for a labor check, we can send one without telling them. I've only done it once without asking, actually was screening for a UTI but the pt. had really dilated pupils so I just added a UDS to it. Otherwise, any pt. being admitted with any history of drug is asked for a urine sample and I personally have never had anyone refuse.

Technically, the docs can drop a pt. from care if they had signed a consent before and are now refusing.

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Specializes in NICU.

I think that the comment about allnurses not being private is meant to remind us that we are sharing information for anyone to read and should be cautious about sharing patient stories for purposes of privacy of the patient and the possibility that the patient herself could stumble across this post. This doesn't mean we can't share stories, but to be cautious about what and how much we share!

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:yeahthat: You know, when I first read this thread..I thought the same exact thing. Is an elevated HR the only reason to suspect drugs in this case? Certainly there are many explanations for an increases HR, as the above poster mentioned. I would probably investigate more before going to the drug screen...but that is just me.

Sorry, I didn't give all the information. I believe the pt. was late to care, had a drug history, and didn't provide sample after nurse asked several times. Pt. finally left sample and it was + but the pt. left the hospital. I just wanted to know what other nurses would do if you had reason to suspect a pt. was using drugs. I probably didn't give all the necessary info. Thanks.

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