I'd skill her @ least 14 days since you're obviously using skilled nursing
observation to monitor her status. After the 14 days, I'd take another look
to see just how often she is getting her additional Lasix and to see if
weight has remained stable. IF weight is stable, additional Lasix rarely
used, and no other problems present, I'd take her off.

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of
Wiedemann, Betty R
Sent: Wednesday, November 19, 2003 9:54 AM
To: List Server (E-mail)
Subject: question to continue skilling


Please look at this scenario and give me your opinion. I'm torn

Rt. with COPD admitted to us from another facility. With in 24 hrs was
transferred to the hospital with pleural effusion and CHF,  where she had
her 3 day qualifying stay.
Was in therapy and could not progress D/T dyspnea
We have been doing daily assessments including pulmonary status eval, wt.
which are Dr ordered to maintain wt at 100 or <. We are not adjusting Oxygen
and occasionally giving additional Lasix.

This appears to fit the criteria but she is so chronic and I don't see this
changing much. Do We cont. skill.?
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/----------------------------------------------------------
The Case Mix Discussion Group is a free service of the
 American Association of Nurse Assessment Coordinators
      "Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
         questions posted to NAC News and FAQs.
    For more info visit us at http://www.aanac.org
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