What order should i put my diagnosis in?

Published

I am working on a careplan/concept map but my pt was admitted with cellulitis, urinary retention, and CHF.... should i work on the cellulitis because he had pain 5/10 or the CHF because he still had crackles in the bases after receiving Lasix? the urinary retention is related to hisCKD...please help me thanks.

Pt is fluid OL because of urinary retention Bhopson08 clearly stated. If you give more lasix where will the other fluids going you think? Whats going to happen to blood pressure?

No, the definition of urinary retention is not prerenal or renal, it's postrenal, meaning it's a mechanical problem with emptying the bladder. Could be an obstruction, could be a hypotonic bladder, could be psychological, even.

CKD may mean the patient makes less urine, but that's not retention. Lots and lots of people with CKD get furosemide so they MAKE more urine. Do you understand the mechanism of action of furosemide? (We can wait while you look it up.)

Giving Lasix (furosemide) doesn't make (whatever you meant by "other") fluids go anywhere. You can give it to someone with no kidneys at all and nothing will happen to fluid volume status or BP. I have no idea what you are talking about, and, I suspect, neither do you. Could you clarify just what the heck you mean?

Up Vote Up Vote ×
Specializes in Nephrology.

Are you listening to yourself with your "could be an obstruction" etc.? May I ask. Do you have an experience working with renal patients? If so.. dont you want to check creatinine or BUN levels if its elevated creatinine clearance is low d/t CKD, are you still going to give it to them? What lasix does with calcium? What will happend if it goes low? Do you know the contraindications of it? Ask nephrologist or I think your the one who needs to search about furosemide.

Giving lasix with no kidneys at all? I think your being funny now. What do you think that kidneys do? You think its like an appendix that does nothing? LOL. And just like what i have said last. Understand the whole problem. The end.

Up Vote Up Vote ×
Specializes in Emergency.

Jayjay,

How does ckd turn into no kidneys at all in this case? The OP talks about retention, what causes that? And how is it corrected?

You have almost a year of experience under your belt and are insulting some of the best instructors on AN. Wow

Up Vote Up Vote ×
Specializes in Nephrology.

Oh my.. read pls. Im not the one who says no kidneys. It was GrnTea. I have 1 year of experience here in US but I already have experience prior to that. Pls read ok? Just wow.

Up Vote Up Vote ×
Specializes in Nephrology.

I dont know why you guys being like that but just like what ive said understand the whole problem. And read previous post not just the OP and the last comment. Geez!

Up Vote Up Vote ×
Specializes in Adult Internal Medicine.
I dont know why you guys being like that but just like what ive said understand the whole problem. And read previous post not just the OP and the last comment. Geez!

If you think that urinary retention is caused by CKD then you don't understand the problem.

If you think lasix isn't used in management of CKD, especially in the setting of CHF, you don't understand the problem.

Sent from my iPhone.

Up Vote Up Vote ×
If you think that urinary retention is caused by CKD then you don't understand the problem.

If you think lasix isn't used in management of CKD, especially in the setting of CHF, you don't understand the problem.

And if s/he didn't understand what I was talking about in a hypothetical, to get him/her to explain about what you think furosemide does regarding ?fluid shifts, then s/he doesn't understand this whole discussion.

OP, can we get back to what you understand and what your thoughts are about your assignment? What do you think, and why? How can we help?

(thanks for the kind words, emtb2rn :) )

Up Vote Up Vote ×
+ Join the Discussion