Author: G. Enevievecragoe

On Sunday afternoon I put away all my gadgets for several hours and took a break from studying. I asked my sister to go on a walk with me around the neighborhood, which she agreed to, but I had a heck of a time convincing her to leave her phone at home. As we were walking my sister asked if I asked her to walk because we needed to talk about something serious. I laughed and said no, but as I thought about it later I realized that we really only put down our devices and give each other undivided attention when something is really serious. We have the mindset that our interpersonal interactions are cheap and commonplace, but those moments are what give us life. 

When this concept is applied to the clinical setting, it makes me realize the importance of connecting with patients. By using technology in a healthy way I hope to show them that I care, that I’m listening, and that they are important. Technological devices are wonderful tool that make incredible impact on the work we do, but we need to be mindful of when they become a crutch in our interactions.

Group Activity – Hepatitis B (Christine Martinez, Brianna Hanzmann, Genevieve Cragoe)

Who? (Who gets it) Intravenous drug abusers, sexually activity with multiple partners, healthcare personnel, hemodialysis patients

What? (What is it – pathophysiology) Systemic viral infection; acute – jaundice, nausea, vomiting, joint pain, rashes, marked elevations in serum liver function tests; chronic – asymptomatic, detected by blood tests, cirrhosis, portal HTN, hepatocellular carcinoma

When? (Frequency, when, related to?) Occurs when exposed to blood or other bodily fluids; once transmitted there is a long incubation

Where? (Systems affected) Causes necrosis and inflammation in the liver, spleen enlarged and palpable, lymph nodes enlarged

Why? (Why does this occur – Risk factors) Transferred through blood, percutaneous, permucosal routes; can be transmitted through mucous membranes and breaks in the skin

Furosemide inhibits sodium and chloride reabsorption in the loop of Henle and in the distal renal tubule. Due to this blocking, the excretion of water and electrolytes (such as sodium, chloride, magnesium, potassium, and calcium) increases. With an increase in the excretion of excess fluid, blood pressure is lowered, which eases the strain on the kidneys. Overall the drug aids in the effectiveness of the kidneys for those who have impaired renal function.

When taken orally, about 60-67% is absorbed in the stomach. If administered by intramuscular injection, Furosemide is absorbed at the injection site.

For patients with renal impairment caution should be taken as this drug increases the risk of ototoxicity. The regular dose may need to be adjusted as the half life of Furosemide increases for renal patients. The regular initial dose is 20-80 mg/day (PO). With renal patients, the dose can be increased to 2.5 gm/day.

Patients should have fluid status assessed as well as the electrolyte and lab values monitored. There can be decreased levels of potassium, sodium, calcium, and magnesium and increased BUN, serum glucose, creatinine, and uric acid levels. It is important for renal patients to be taught to monitor their daily body weight.

Here’s a photo which I feel describes me pretty well. It was taken about 3 years ago when I was learning Spanish in Mexico. I went on a trip with the clinic that partnered with my school. I was taking vital signs here, but I really had no idea what I was doing.

Overall, this photo displays several things about who I am: I love travelling to different places, caring for others is deeply important, and even when I feel like I’m in over my head I still strive to do my best.

My favorite lab value is glucose (74-99 mg/dL). It’s fairly easy for me to remember and it has stuck with me after getting to perform many Accu-Chek glucose tests.

My least favorite lab value is hematocrit (38.8-50.0). I can become easily confused between hemoglobin and hematocrit and sometimes have difficulty telling the difference between the two.

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