stupid question about weight.

[Blackheartednurse]

Ok so I'm a little bit confused about the weight issue. I work in a home health care and I visit people in their homes.I'm required to weight the patient either weekly or monthly, weekly for CHF patients.Well anyway our agency protocol states to notify MD if patient gain or lose 5 pounds.This is where my confusion starts I'm more confused about the gain,do I notify the doctor only when the patient gain or pounds SINCE the admission? What about if for an example on admission it is established that the patient weights 120 pounds,than patient loose 5 pounds so now he/she is 125 (so lets say I notify the MD of the weight loss).Now week later patient gain back those pounds and now again he is 125 (do I notify MD again?) Basically my question is do I count the gain weight or loss only from the admission time or any particular visit time?

[klone, MSN, RN]

I think that's something you would need to ask your facility or the overseeing MD.

[ebear, BSN, RN]

I would do the weight reports from the time of admission, which is more than likely when the order was written/received. With CHF patients, you are far more concerned with weight GAIN due to fluid overload. Don't fail to report it. Dehydration is possible with fluid LOSS, resulting in weight loss.

[canesdukegirl, BSN, RN]

Yes, you are correct. If the patient upon admission weighs 120 and then during your visit weighs 125, report it. If they are 115 during your visit, report that as well. Your confusion seems to whether or not to report fluctuations when upon another visit, your patient is at the baseline weight. Let me make sure I am clear on your question:

Baseline 120

First visit, 125. Protocol is to report the gain.

Second visit, 115. Protocol is to report the loss.

Third visit, 120. You would ALSO report this as a gain, even though it is baseline.

Was that your question?

[systoly]

You report both. A 5 lbs deviation from baseline as well as a weekly deviation.

If you don't report the deviation from baseline, the patient could gain 4 lbs every week for a one month gain of 16 lbs without any reporting taking place.

You have to report a weekly deviation of 5 lbs or more, because regardless of baseline it does fall within the parameters to report.

[Blackheartednurse]

Yes, you are correct. If the patient upon admission weighs 120 and then during your visit weighs 125, report it. If they are 115 during your visit, report that as well. Your confusion seems to whether or not to report fluctuations when upon another visit, your patient is at the baseline weight. Let me make sure I am clear on your question:

Baseline 120

First visit, 125. Protocol is to report the gain.

Second visit, 115. Protocol is to report the loss.

Third visit, 120. You would ALSO report this as a gain, even though it is baseline.

Was that your question?

yes,thanks!