VDRF Correlation w/ Lab/Test Results -- Help!

ckh23, BSN, RN · Feb 14, 2012

Are you trying to correlate with how the patient's status is now or was? Technically if he is on trach collar he is no longer VDRF.

I don't think you are comparing the VDRF alone, but instead looking at the whole picture.

Double-Helix, BSN, RN · Feb 14, 2012

Okay so...
I received a new patient today for tomorrow's clinical and he was admitted with VDRF secondary to a bowel obstruction that was caused by an incarcerated hernia. He actually also has a history of sigmoid volvulus which also lead to bowel obstruction two years prior. I am to find a correlation with the pathophysiology/lab & test results. Would you suspect that I am comparing the VDRF, alone, with lab results?
Background info for you: He has actually been weaned from the vent and now has a trache collar. He has both a Passy Muir and cap for his trache... (hopefully that's how you would word that).
I guess what I'm trying to figure out is what am I trying to correlate here? Any suggestions?

It sounds like you can correlate lab results with any part of the patient's condition. While he may have been admitted to ICU with with diagnosis of VDRF, he no longer really has that diagnosis because he is not ventilator dependent. Since he has a cap for his trach I take that to mean that he no longer is using the trach for ventilation and is probably in the process of being downsized until he can be decannulated.

My first question is whether you have to use recent lab values or any lab values from the admission. For the VDRF it would certainly be possible to review the chart and find ABG results prior to mechanical ventilation that would support the VDRF diagnosis. Chest x-rays are also important to look at.

For the bowel obstruction you'll want to look for signs of infection that could indicate perforation or sepsis: WBC, bands, CPK. More importantly your test results: x-ray, CT, upper Gi series.

Basically if your patient's admitting diagnosis is no longer a continuing issue then you'll have to use past lab results to find the correlation that you need. Hope I helped!

MJ_14 · Feb 14, 2012

Thank you so much, both of you! That was a tremendous help! I figured I should go with lab results related to the bowel obstruction, but the diagnosis of VDRF even when they are off of the vent always throws me for a loop! Again, thank you guys so much! :up:

MJ_14 · Feb 14, 2012

What would you say were the top 3 problems for my pt? He is also cachexic so I'd say that would be one of three. Impaired gas exchange would be another guess... and deficient fluid volume to the bowel obstruction.