Things that leave you stunned.

shugrr22107NA · Jul 4, 2009

aside from amazement my first thought was, that lady would make a GREAT Nurse....she could go a whole shift before a break!

We recently had a PT with a huge bladder also, his skin was suffering and has improved greatly since the cath...now if we can just keep him from messing around with it until his treatment!

Looking forward to hearing more on this thread, the human body is amazing!!

KateRN1 · Jul 4, 2009

The man who drove himself to the hospital in VT because he didn't think his wife was a good driver.

Chewie_123 · Jul 4, 2009

Nevermind...

nolabarkeep · Jul 4, 2009

The mom who brought her two teens to the ED for vague cold like symptoms and became irate when we explained to her that she had to stop eating her boiled crabs in the room. :bugeyes:

morte, LPN, LVN · Jul 4, 2009

I thought it would be interesting to share stories about things we've seen that just totally amaze us.
Here is my story.
I was helping a collegue cath a pt yesterday. This pt was incontinent of urine - large amts (this is important) and her bottom was so excoriated it was bleeding. So we decidied a cath would help this heal.
She voided a large amt (important) while we were positioning her, but we went ahead anyway.
Got the cath in - it drained 2200 cc (not a typo) in less than half an hour! We were stunned. We clamped the cath because we were worried about side effects from draining so much so quickly. Unclamped an hour later and got another 1000cc! We are still in shock. Plus, the urine was very clear - not the concentrated gunk that you usually get when someone is in retention. This ladie's bladder must have been the size of a basketball!
Her abd certainly was softer after all of this!

my first thought was high outpyt renal failure....

NurseKitten, MSN, RN · Jul 4, 2009

my first thought was high outpyt renal failure....

High output renal failure or diabetes insipidus.

Need labs, and an ADH level. She might need some DDAVP.

mama_d, BSN, RN · Jul 4, 2009

Had a patient with mesothelioma (I think I spelled that right) who had so little lung function left that his CXRs kept saying he had had his right lung removed...he hadn't, it just was very teeny tiny. Satting 98% on room air with no SOB, even with activity. He looked totally healthy until you saw his CXR.

We've got a couple of oncology patients who are fighting tooth and nail against their cancer and still manage to always have a smile on their face and a thank you for the staff, even when they're in the midst of puking their guts out and in so much pain that you can practically feel it emanating from their body, even when they know it's most likely hopeless and they'll be leaving their families behind within a few years at the most. Those people amaze me. They make me want to drag my overdramatic, whiny, "why are you starving me just because I complained of chest pain" patients into their room and say "Do you see this? This is true suffering, suck it up, not eating from midnight to 8 am is not going to kill you, this is what something killing you looks like. And they're still smiling and polite."

Oz2 · Jul 4, 2009

We clamped the cath because we were worried about side effects from draining so much so quickly.

Can I ask a question (I'm not a nurse yet)? What would happen if you let it all drain out? I would feel nervous about clamping it off....like maybe it would burst her bladder!

susannyc · Jul 4, 2009

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We've got a couple of oncology patients who are fighting tooth and nail against their cancer and still manage to always have a smile on their face and a thank you for the staff, even when they're in the midst of puking their guts out and in so much pain that you can practically feel it emanating from their body, even when they know it's most likely hopeless and they'll be leaving their families behind within a few years at the most. Those people amaze me. They make me want to drag my overdramatic, whiny, "why are you starving me just because I complained of chest pain" patients into their room and say "Do you see this? This is true suffering, suck it up, not eating from midnight to 8 am is not going to kill you, this is what something killing you looks like. And they're still smiling and polite."

I work with oncology patients also. I agree with you--the sickest ones are always the ones who are the most polite. i recently had an end stage cancer of the omentum patient tell me that "I don't think I need help at home, I'm sure there are other people who can use these services. I have my family." I convinced her to take services anyway, just in case her family members needed a break.

I found the same thing with trauma patients too--the ones with the worst injuries were always the most understanding.

ChristineN, BSN, RN · Jul 4, 2009

Can I ask a question (I'm not a nurse yet)? What would happen if you let it all drain out? I would feel nervous about clamping it off....like maybe it would burst her bladder!

Losing a large amount of fluid in a very short period of time can be bad for a pt. The pt might become hypotensive. As a result, you need to try to remove it gradually. Since the pt had already voided 2200cc, it's highly doubtful she's going to burst her bladder. Plus, I'm guessing the OP didn't leave it clamped for very long, maybe an hour or two.

NurseKitten, MSN, RN · Jul 4, 2009

Can I ask a question (I'm not a nurse yet)? What would happen if you let it all drain out? I would feel nervous about clamping it off....like maybe it would burst her bladder!

Bladder is innervated by the parasympathetic nervous system, primarily. The "rest and digest", "feed and breed" system.

If you allow it to drain so rapidly, you provide a HUGE stimulus to the PSNS, and could precipitate a drop in heart rate, cardiac output, blood pressure, etc etc etc.

Of course, depending on who you talk to, some don't clamp at all and just let it drain.

But if someone's putting out that much urine, that quickly, and the IV fluids AREN'T running wide open, something else is seriously going on.