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Haunting story from the ICU

So I came in my shift my pt was a 90 year old pt she was sedated and intubated. Diagnosed with AAA, Abdominal aortic aneurysm type A. Basically a bulging or ballon like bubble in the aorta that needs immediate medical attention can result in death by bleeding to death from the inside.

Family wanted time to decide what to do so we extubated the pt and waited for the sedation to wear off to get her opinion. It was taking a long time so family went home for the night around 8pm.

At 4am I walked past her room and to my surprise she was sitting up. Since arriving to work pt has not moved at all so I walked into the room. She was sitting up turned to me and smiled asked me when her daughter was coming back. I said soon I will call her right now. She said thank you then smiled. I turned and left the room picked up the phone called her daughter as soon as I started talking I hear the alarms. I put the phone down run to her room asystole rhythm, no pulse, pt eyes tell me everything. She has passed away. I can’t help but notice her neck is pulsing extending outwards almost like a toad. The aneurysm has burst and she was bleeding to death internally. All within minutes she woke up asked for her daughter then died. She smiled when talking right before she died so I tell myself she died happily thinking her daughter was on her way.

Nursing

Early pregnancy miscarriages some types..facts.. and myths

Early pregnancy loss less then 20weeks is called a spontaneous abortion. After 20, it is called stillbirth. There are different types and causes. So I’m just going to touch on the different varieties with brief descriptions.

CHEMICAL PREGNANCY

Usually happen before week 5. Some woman aren’t even aware they are pregnant. So the sperm fertilizes the egg, but implantation never happens. The body passes the egg and usually heavy bleeding occur, so sometime a woman may not know a miscarriage happened. She may think she is late with heavy menstrual flow.

ETOPIC PREGNANCY Fertilization happens outside the uterus, in the Fallopian tubes. Very dangerous and painful. Not viable for life.

BLIGHTED OVUM also called an anembryonic pregnancy, the fertilized egg implants on the uterine wall, but no embryo develops. Meanwhile the gestational sac develops, eventually will stop developing and will pass with dropping hormone levels.

MISSED PREGNANCY Egg gets fertilized, implantation occurs, but for varies reason the embryo stops growing.

MOLAR PREGNANCY Egg gets fertilized, implantation occurs, embryo develops but there is tissue overgrowth. The embryo may have missing parts, abnormal placenta, complete and partial molar pregnancy cannot sustain life. GTD and Choriocarcinoma usually are discussed in molar pregnancies. These are just a couple of different types of miscarriage. All with different causes.

SOME CAUSES Chromosomal, Immunologic, Diabetes, Thyroid, Blood clotting disease, Infections, Hormonal, Uterine abnormalities (septum, polyps), lifestyle such as drugs and alcohol. MYTHSMiscarriages are rare, not true.Heavy lifting early trimester cause miscarriage, false.Past abortion will cause a miscarriage, false.Drinking coffee will cause miscarriage, falseStrenuous exercise will cause miscarriage, false.It is the woman’s fault, false.

SYMPTOMS Back pain, fever, cramps, bleeding, abdominal pain, weakness, if you are experiencing any of these symptoms while pregnant please seek emergency help.

Just touching on different types there are more but mainly just making people aware of the difference in early pregnancy miscarriages. Have any questions or want to add or debate the list feel free to comment or contact me.

Nursing

Things you shouldn’t find “inside” your patient’s… but you do. 

               So you come in to work, get report everything seems normal, and the prior shift leaves. So you go back in to see the patient, and they have a rectal tube, rectal catheter, however you refer to it. So it looks…different. 

     There is liquid in the collection bag , but it’s clear, small amount. Maybe they just change the bag. So you go to flush it and light clear pink tinged water comes out. Ok. So you look closer and realize it’s inside the vagina!!!! I believe the nurse went and got a second opinion just to verify. And yup it was inside the vagina. 

     This is bad .. real bad. I mean COME ON!! besides the complications this may cause, hello!!!! This is really bad!!! How this happened no one knows. Ok one the rectal bag goes in the rectum, and  two, pretty much nothing should be inserted in the vagina. 

     If you don’t know how to do something just ask, please just ask… please!!!