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BellaOnline's Geriatrics Editor


Hospital Tips, An Excerpt from Patient Whiz

Guest Author - A. Maria Hester, M.D.

The following tips can save your life when you are hospitalized:

1. When your nurse administers a medication, ask why you are taking it. This may help decrease potential medication errors, which happen far more frequently than most people realize. It will also help you to understand the conditions for which you are being treated.

Many medications come in generic equivalents these days. Chances are, you may just be getting one of your regular medications that looks different because it was manufactured by a different company. There is also the possibility that you are receiving a new medication to treat a new problem. You have the right to know about this.

If you have any medication allergies, inquiring about every pill you take may
help prevent a potentially serious adverse drug reaction.

2. Get a business card from all of your doctors, including specialists. You may have questions after discharge.

3. Try to get up and walk around as soon as possible. Lying in bed for several days significantly increases the risk of developing a blood clot in your legs, called a deep venous thrombosis (DVT). When part (or all) of a DVT dislodges from the veins in your legs and travels to an artery in the lungs, it results in a pulmonary embolism (PE). This is a potentially lethal condition that kills more Americans each year than breast cancer and AIDS combined!

If you are unable to ambulate, you should discuss DVT prophylaxis with your physician. This generally consists of 1-2 daily shots beneath the skin to keep
your blood thin or sequential compression devices (SCDs). The latter are balloon-like devices that inflate regularly to help keep the blood flowing in your legs.

4. If you have been too ill to walk for several days and you are not sure if you will have the strength to get around your home after discharge, ask your physician if you can have a physical therapy evaluation. It is common for patients to need a physical therapy evaluation prior to discharge after having been bedridden for a few short days.

5. Let medical personnel know whom they may speak with on your behalf. Many people do not choose to allow every familymember access to private health issues. Be prepared to give your doctor or nurse the phone numbers of one or two family members whom they may contact to discuss your care and/or make medical decisions on your behalf. In addition, when acutely ill, most people lack their full mental capacity. Thus, explanations and instructions from your physician may be easily forgotten. By having a family spokesperson who can get regular updates, you will have an extra layer of protection to ensure a
smooth and safe transition from hospital to home.

6. If you are getting IV fluids and you are eating and drinking well, ask your physician if there is an ongoing need for fluids. Sometimes patients get excessive amounts of fluid. In certain instances, excess fluid goes to the lungs and causes shortness of breath. While it is common practice to start IV fluids on admission, sometimes people get more than they really need.

7. Get the catheter out of your bladder as soon as possible. In many cases, patients need long-term use of a catheter; at other times, patients prefer it for convenience. (They do not want to use a bedside commode or a bedpan.) However, urinary tract infections are far more likely to occur in patients with a bladder catheter. So if you do not absolutely need it, ask that it be taken

8. Understand the difference between a DNR (Do Not Resuscitate) order and your Living Will/Advance Directives. Most people would not want to kept alive artificially for a prolonged time. They have expressed their specific desires in their Living Will/Advance Directives. However, that does not mean that in the event of an acute, unexpected cardiac or respiratory arrest they should not have a chance at resuscitation. Many things can cause the heart or lungs to fail besides those that are uniformly fatal. For instance, a low blood magnesium or potassium level can cause potentially serious heart rhythms that can be easily treated. Likewise, septic shock does not always lead to death.
Sometimes people just need a few days on a ventilator to let their lungs rest while the antibiotics kick in and do their job.

If the nurse walks into your room at 2 am and you are on the verge or a cardiac or respiratory arrest, she must make an immediate decision about whether to call a code (better known as code blue). No one will know just by looking at you if your potassium level is out of whack or if there is something far more serious. If they do not resuscitate you and run basic tests to try to get to the root of the arrest, your life may be lost over
something that could have been completely reversed very quickly.
You may certainly explain to your doctor that in the event of an acute cardiac or respiratory arrest, you would want to be resuscitated. But if diagnostic tests reveal a condition that is so severe it is unlikely you will regain any significant qualify of life, then you would like heroic measures to be discontinued.

The above excerpt was taken from the Patient Whiz.
Editor recommendation:
The Patient Whiz is a credit card-size 1 GB USB flash drive that easily fits into your wallet to empower you to keep copies of EKGs, lab results, medications lists and much more with you at all times. It doubles as a patient empowerment tool with articles such as the one above.
Click on Patient Whiz to take you to the site to learn more about the Patient Whiz

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Content copyright © 2015 by A. Maria Hester, M.D.. All rights reserved.
This content was written by A. Maria Hester, M.D.. If you wish to use this content in any manner, you need written permission. Contact Patricia Villani, MPA, PhD for details.


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