Rn's Urgent Help Please !!

[Samantha999]

I Am The Mother/garegiver To A 32 Year Old Son Who Is Non-verbal And Dx'ed With Lgs. He Is On A Lot Of Anticonvulsants. Just Over A Bout Of Gladder Infection And On His Second Round Of Raging-----severe Reflux !!!!!!
I See The Doc Tomorrow And He Is On A State Program That Will Pay For 14 Hours Of Nusing Care A Week. But But But The Doc Has To Write Up The Order And Then I Can Proceed To Get Some Help.

My Son Is Not Thriving. His First Bout Of Reflux Ended 2 Years Ago And He Gained A Good Amount Of Weight But Over The Past Month And A Half He Has Not Been Able To Eat Mor Thatn A Couple Of Bites Of Food. He Is On Prevacid Twice A Day But It Is Not Helping. To Get His Meds To Stay Down And Something To Eat To Stay Down And To Keep Him Hydrated Is Just About More Than I Am Able To Do. O But I Am Getting Good At It. Finally Resorted To High Calorie Boost............

He Throws Up The Most Yuky Mess Of Phlegm And Mucus....and Is In A Lot Of Pain Until He Does. This Was Until I Just Decided To Keep On A Liquid Diet Until Some Healing Starts To Occur. Stuff Gets Stuck In His Esophagus And Then The Fluid Builds Up Around It. It Is Awful For Him.

I Need The Expertise Of A Rn.

What Should The Orders/script Say????? Please Help Me.

[chunky]

What ever the MD writes, if you are going to obtain help from the inusrance carrier; the needs must be addressed by a skilled person and not that of custodial care; ie: RN assessment for : respiratory -is he aspirating, gastrointestinal- does he has bowel sounds and nutritional -is he adequately hydrated, what are his medications and is he having side effects, blood pressure-any meds for this; the idea is that he needs a home health for skilled needs that you can not meet. This might get you some coverage and respite help to define what kind of skilled needs he has if any...
Other RN's may have more to add but that is my recommendation in a nutshell
I hope this helps.
D

[Samantha999]

Thank You Chunky For You Imput. It Was Helpful And I Will See What Happens And Keep You Posted.
The Script That THe Doc Wrote States His Dx And The Fact That Blood Was In The Urine. That He Is Not Thriving And Due To His Needs His Family Would Like To Have Help For Nutrition And Other Needs...................
I Gave That To His Case Worker. She Wants A Pt To Access Him-go Figure.
I'll Push If This Bout Of Reflux Does Not Subside Soon.
I Am Certified For Delegated Nursing Which Means That I Can Give Meds Take Blood Pressure Listen For Bowel Sounds Etc. But Not Shots Or Know Signs And Symptoms And Why I Need The Expertise Of A Visiting Nurse To Address Any Concerns. Wish Me Luck.

[Kitty888]

Hi,

I hate to bring this up, but if he is having trouble swollowing and has decreased appetite etc, maybe you could discuss with your family doctor about possibly have a GT place. It is not hard to take care of and you could ensure adequate fluid intake. part of his urinary issuses might be related to dehydration.

Best of luck to you and to him.

Kitty

[Samantha999]

Holding down solid food (small single portions) and water. Had a large bowel movement on the 26th and feels better because of.
So even without the help of a nurse and the tricks of the trade I have been able to find THE WAY to help him through this.
Just thanking the good lord above for his guidance.

[Samantha999]

Well,
It is October 2008 and my son has rebounded. I did not receive any help from outside RN etc. I slowly reduced the keppra and he is off of it altogether now.. He had a kidney cat scan and his kidneys are/were normal. So without being able to know exactly what was going on with him....reflux and the throwing up etc. The removing of the keppra was my safest bet. Of course his seizures are worse and he is on as much felbatol as is allowed plus some depakote. He does not take reflux meds anymore.
He has gained all his weight back and then some and is a happy camper as far as I can tell.
So onward and ever upward!