a case to discuss

[canavarim]

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So we had this 30 something patient coming for abdominal closure . He had an accident a 2 years ago , had e lap , colpicated postop lenghty ICU care .... but now he is coming from home for this . He is on no medication, sleeping most of the interview 🙂 , admitts to chronic cough since the hospitalisation with some yellow0green phlegm sometimes . He was on a course of levaquin which he finshed and he says he as good as he gets regarding that . On PE he is wheezing diffusely , sat are on the 90-95% RA. CXR ordered and was N . Ofcourse we cancelled the case . But I still asking how to optimize this guy and what might be the cause of this desat. and wheezing ??

 

[Noyac]

Umh What?

I am having a hard time following your post.

If you are a Dr? Could you present your case as so?

If you are a nurse, then it shows.

 

[Bougie]

That presentation sounded like something the nursing student who woke me up at 3am last week would have said...

Um, sir...Mr X's epineural is beeping and he wants to know if he can have a donut...

Good thing she was hot.

 

[coprolalia]

Good thing she was hot.

Yeah, funny, and at the same time very sad, how that makes up for a lot.

There is this really hot medicine intern who basically killed a patient a coupla months ago. She was following this lady who got stuck in the MICU post-op for lack of beds. Long story short, the lady became progressively anuric over a couple of days. When the uremia mad her all screwy and loopy, what did this intern do? Haldol 5mg IV. Next morning the patient was dead.

The truly sad thing is that she has so many people enamored of her, because she's blonde, thin, and has a nice body, that I seriously doubt any serious repercussions will come from it.

👎

-copro

 

[militarymd]

you're just jealous.

Yeah, funny, and at the same time very sad, how that makes up for a lot.

There is this really hot medicine intern who basically killed a patient a coupla months ago. She was following this lady who got stuck in the MICU post-op for lack of beds. Long story short, the lady became progressively anuric over a couple of days. When the uremia mad her all screwy and loopy, what did this intern do? Haldol 5mg IV. Next morning the patient was dead.

The truly sad thing is that she has so many people enamored of her, because she's blonde, thin, and has a nice body, that I seriously doubt any serious repercussions will come from it.

👎

-copro

 

[radslooking]

what? you couldnt tell this person was a doctor from the smiley face after "he was sleeping during much of the interview"? lol. Well, I'll chime in and say that perhaps this person has some reactive airway disease post respiratory complications, (possibly ARDS-but have no history). Or he could just have regular asthma. Its possible his lung function is just not back to par with the low sats. Its possible his sats haven't been checked in a while...or if they have, havent set off any alarms because he's still 90%+.

 

[radslooking]

Yeah, funny, and at the same time very sad, how that makes up for a lot.

There is this really hot medicine intern who basically killed a patient a coupla months ago. She was following this lady who got stuck in the MICU post-op for lack of beds. Long story short, the lady became progressively anuric over a couple of days. When the uremia mad her all screwy and loopy, what did this intern do? Haldol 5mg IV. Next morning the patient was dead.

The truly sad thing is that she has so many people enamored of her, because she's blonde, thin, and has a nice body, that I seriously doubt any serious repercussions will come from it.

👎

-copro

well, she must have a good face, because blonde and thin shouldn't do that much for you, even in fat America.

do you know why this patient was anuric?

 

[Bougie]

mmm...blonde..thin...

Hospital hot.

We have a resident like that. You wouldn't even notice her if you were at a bar and only had one shot of Jager. However, she's OK to look at if the only other thing to look at is a Fournier's debridement on a 400lb dude who hasn't bathed in a year. She absolutely loves the attention at work since when she steps out she goes back to being a plain jane.

To answer the OP: I would recommend a modified rapid sequence tracheostomy followed by renal dose dopamine and P6 acupuncture. He'll do fine.

 

[coprolalia]

do you know why this patient was anuric?

Yeah, because a medicine resident should never manage a surgical patient. 😉 The patient's K+ the morning the she died was 7.6. The creatinine had gone from 0.8 to 2.6.

-copro

P.S. Yes, she has a great face too. Believe me, she plays it up. Likewise, I'm not jealous (I've got a nice little thing going on with my own nurse-hottie). I just hate how a so-called professional uses her looks to, literally, get away with murder (which is, for all intents and purposes, what she did to this patient).

 

[Gern Blansten]

To answer the OP: I would recommend a modified rapid sequence tracheostomy followed by renal dose dopamine and P6 acupuncture. He'll do fine.

Very nice!!

 

[cchoukal]

Yeah, because a medicine resident should never manage a surgical patient. 😉 The patient's K+ the morning the she died was 7.6. The creatinine had gone from 0.8 to 2.6.

-copro

P.S. Yes, she has a great face too. Believe me, she plays it up. Likewise, I'm not jealous (I've got a nice little thing going on with my own nurse-hottie). I just hate how a so-called professional uses her looks to, literally, get away with murder (which is, for all intents and purposes, what she did to this patient).

Yeah, you mentioned your little nurse hotty but haven't really followed up on the situation... any updates?

Whoever mentioned the term "hospital hot" was right on. We use the term "hospital goggles" around here, and they seem to come on right around july 1st when, coincidentally, all the new interns show up. There is definitely a sliding scale in the hospital...

 

[coprolalia]

Yeah, you mentioned your little nurse hotty but haven't really followed up on the situation... any updates?

I'll let you check-in with Jet. 😀

-copro

 

[toughlife]

So we had this 30 something patient coming for abdominal closure . He had an accident a 2 years ago , had e lap , colpicated postop lenghty ICU care .... but now he is coming from home for this . He is on no medication, sleeping most of the interview 🙂 , admitts to chronic cough since the hospitalisation with some yellow0green phlegm sometimes . He was on a course of levaquin which he finshed and he says he as good as he gets regarding that . On PE he is wheezing diffusely , sat are on the 90-95% RA. CXR ordered and was N . Ofcourse we cancelled the case . But I still asking how to optimize this guy and what might be the cause of this desat. and wheezing ??

Medical optimization of a patient prior to surgical intervention should be deferred to your supervising anesthesiologist and it's not to be performed by an SRNA/CRNA as it represents practicing medicine without a license.

 

[radslooking]

mmm...blonde..thin...

Hospital hot.

We have a resident like that. You wouldn't even notice her if you were at a bar and only had one shot of Jager. However, she's OK to look at if the only other thing to look at is a Fournier's debridement on a 400lb dude who hasn't bathed in a year. She absolutely loves the attention at work since when she steps out she goes back to being a plain jane.

To answer the OP: I would recommend a modified rapid sequence tracheostomy followed by renal dose dopamine and P6 acupuncture. He'll do fine.

as you know, there is no such thing as a modified rapid sequence tracheostomy. it is either a rapid sequence tracheostomy or nothing at all. where did you train? 😉

 

[Planktonmd]

Medical optimization of a patient prior to surgical intervention should be deferred to your supervising anesthesiologist and it's not to be performed by an SRNA/CRNA as it represents practicing medicine without a license.

😍

 

[ecCA1]

Reviewing his/her previous posts:

1. What is a good drug for naseau?

2. How do you learn TEE?

etc.

Clearly, no resident would need to ask such inane questions.

Back where you came from, pal:

allnurses.com

 

[Strength&Speed]

Reviewing his/her previous posts:

1. What is a good drug for naseau?

2. How do you learn TEE?

etc.

Clearly, no resident would need to ask such inane questions.

Back where you came from, pal:

allnurses.com

lol, what's a good drug for nausea. Like there's so many unique drugs to choose from