Renal Failure questions

[dragonflyaltoids]

I am an ADN student and I work as a patient care tech in a small hospital. Yesterday, I had a lady in renal failure who is obviously about to pass on. She had a foley in and was on a nasal cannula. However, when I was changing her I realized (in horror) that she was bleeding from everywhere- her rectum, and I couldn't tell if it was her lady parts or urethra, the smell was very very very overwhelming and I honestly didn't think I was going to get through it. We have to turn her every two hours and everytime we did she would release more. My question is what causes this? And how in the world do I handle it next time? I just wanted to hug her when I was done

[gonzo1, ASN, RN]

I am sorry for your scary experience. It sounds like you did a wonderful job. I am curious why a renal failure pt had a foley in? Is she one of the few who still produced some urine? There are many reasons why your pt may have been bleeding the way she was. If you have a chance try to ask her doctor what his insight is. Or one of the other nurses who have cared for her. It is possible she was in DIC. You can look that up in your nursing book or on the "net" it is a very interesting and unforgetable complication. If you can't find anything on DIC let me know and I will give you more info, but try to look it up yourself first. There should be lots of info on it. Keep doing and learning. God bless and keep you.

[JB CC-RN]

It could be a GI bleed, if she was bleeding from her rectum. It's hard to tell the cause of this without more info. Once you have smelled a GI bleed, you will never forget it.....it has a smell all it's own. If she was bleeding from her rectum, nose, mouth, eyes...etc...it could be DIC.

Very scary, but also a very memorable experience.

[leslie :-D]

it also could be itp, or idiopathic thrombocytopenic purpura, a disease of decreased platelets r/t being destroyed by the immune system.

you would expect to note petechiae, bruising, abnormal menstrual bleeding, and often a sudden and severe loss of blood from the gi tract.

hematologic disorders in renal failure are rather common.

good luck in your studies.

leslie

[jnette, ASN, EMT-I]

My mm patient, whom I had admitted for acute renal failure a couple weeks ago, also had a foley inserted. Her kidney function did return.

I'm sure this was a frightening experience for you.. I know it would have been for me. :uhoh21:

Let us know what you find out. Best wishes.. keep up the good work ...AND the intellectual curiosity ! :)