Doctor insights on:
Hypokalemia Nursing Diagnosis
Why would someone with high potassium/kidney failure need 24 hr nursing care after potassium is normalized? Mom in ICU.
Hard to say: There are a tremendous number of variables that go into the determination of patient needs. A blanket statement about a problem that may or may not resolve with treatment is mere speculation. Some with acute kidney failure improve well enough to go back to work, some require frequent dialysis.The proper assess can only be made knowing all the variables in the specific case. ...Read more
Palliative care question: good reference guideline for end-stage COPD clinical/functional markers for poor response to CPR, and should recommend DNR?
COPD and DNR: I recommend going to uptodate and review what their recommendations are. This is the best source of good medical information I have found. When you read the sections on these issues you can also click on the reference to see the cited reference. ...Read more
Tubular acidosis question. Gfr improves consistently with b12 shot and bicarbonates (sodium bicarbonate). Nephrologists refer dialysis but crt 2.6 to 1.5 with bicarb. !?
Here are some...: Glad to see her acidosis has been improved from taking sodium bicarbonate. Known to us, dialysis is designed for fluid overload and/or electrolyte and acid-alkaline imbalance. Do nephrologists recommend dailysis now or refer for pre-dialysis assessment? So, ask her doctors for specifics and relevance for renal tubular acidosis, dialysis, etc. because online 400-letter does not suffice to address.. ...Read more
50 y/o F, dypsnea,tired,sweating.chron pain right side/spinal fusion ERvisit only abn.was CO2 levs.arterial=33 andvenous Co2=55 init diagnosis pneu, xray ok?
Neurology - not diagnosed looking for info - how quickly does Lambert Eaton Myasthenic Syndrome (LEMS) progress from experiencing the initial symptom?
Start here: Start with http://www.m.webmd.com/a-to-z-guides/lambert-eaton-myasthenic-syndromeGet a more detailed answer ›
See a specialist: You need to be very closely monitored by a high-risk obstetrician and maternal fetal medicine specialist. They will need to coordinate your care very carefully with your cardiologist/endocrinologist and good communication of these team members is essential. You will need frequent visits. ...Read moreSee 1 more doctor answer
What's the care plan for patient with nephrotic syndrome and diagnosed with ineffective tissue perfusion , renal?
Depends: It depends on if it is steroid responsive or not. Treatment can vary - it needs to be individualized. ...Read more
Dementia pt. had aspirational pneumonia D'C'd back to RCFE even tho needs higher level of care. Nursing scvs provided by hospice. Why not sent to SNF?
A different focus: Hospice services are a wonderful asset to have at the end of one's life. We all have an end. When the end is near, we don't go to a skilled nursing facility (think of an SNF as a place to recover and get back to good mental and good physical functioning). When our end is in sight, hospice is the way to go. It lets one die a good death, at home, pain-free, worry-free, in peace and quiet. ...Read more
Brain stroke , hospitalised, pulse fluctauting, BP low, giving saline solution, INR 3.05, waitingto do tracheostomy. will it help to get better?
Tracheostomy : A tracheostomy is performed to control the airway and oral secretions and to prevent aspiration. It is also helpful to get the breathing tube out of the mouth in order to do good mouth care. The tracheostomy is generally a temporary measure until the patient is stronger physically and neurologically. The procedure will not be performed until the anticoagulants are stopped and the INR is reduced. ...Read more
If an elderly person has renal impairment, CHF & hypernatremia (sodium presently 157 mmol/L) would it seem to be appropriate for him to be on a NORMAL SALINE IV fluid? Other conditions are COPD, pleural effusion, T2 diabetes, delirium, mild hepatic dysfun
Multiple med problem: I would consider 1/4 N.S. a more appropriate fluid. Sounds multiple system are failing and he has a very high mortality. If one can correct the CHF and CRF then the other factors may correct themselves, but doubt that Hemodialysis is indicated in a 91 y/o ...Read moreSee 1 more doctor answer
That is o.k.: Your md is trying to make a diagnoses of the dysrrhythmia by doing the holter and that is o.K! ...Read more
A/N/V/dizziness: If i understand question correctly, the nursing diagnosis should mainly address the actual signs and symptoms. So, severe dehydration should not be nursing diagnosis since technically you may call volume depletion by mistake a dehydration. But would be appropriate to say dizziness, weakness, low blood pressure as these are not disputable and not amenable to error. ...Read moreSee 1 more doctor answer
My globally delayed 4 y/o son was diagnosed "idiopathic" by a neurologist, recommendations for further testing?
Cause is unknown: Idiopathic just means that the cause is unknown. It is very difficult to have to deal with/care for a child with disability. Without knowing the full case history, it is difficult to advise you otherwise. I suggest talking/asking the neurologist what are involved in additional testings and what is it that he/she is looking for. I empathize with you that it is very frustrating. Good luck. ...Read moreSee 2 more doctor answers
What's more appropriate for hypokalemia or hypokalemic periodic paralysis? Potassium chloride or potassium citrate? Thanks.
14 month cirrhosis lt ..58/f. Hbp, diab. Asth/w several infections. Pt/arm. Memory.Back sleep.. Moods..Caregiver 60%. Work possible? Adm position?
What is your ?: Are you asking if you can work with these medical problems? There is no way anybody can answer this question without a good history, physical examination and possibly lab tests. How well are all of these being treated, or are they being treated at all? What is the underlying causes of some of these problems? These are questions you need to be asking one or more of your medical providers. ...Read more
5yo child diagnosed with sleep myoclonus, sleep is interrupted, what r essential blood tests required to see wat medical conditions could b causing it?
?????????: Sleep myoclonus is a normal variant seen occasionally. There is no "blood test" to verify or exclude it. The most aggressive investigation that might confirm or exclude it would be a video-EEG with the patients events recorded for clinical review. I would only pursue that if their were concerns for Rholandic epilepsy or similar problem. ...Read more
Pseudohypoparathyroidism? I have "archibald's sign," chronic skin rash, constipation, heart flutter. Come home asap from vet school abroad for dx/tx?
Pseudohypopara: You present a number of medical complaints, all of which need attention. Please start with a visit to your primary doctor. Your medical history will be taken, you will be examined by the doctor, and laboratory studies will be ordered. Once the information is collected your doctor will decide where you might go for further care. Please let me know what develops. ...Read more
Does vitamin D3 dosing schedule influence treatment efficacy in nursing home residents with vitamin d deficiency?
Not usually: No worry, and one adjusts dose anyway depending on results of therapy. ...Read more
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