🚀 go-pugleaf

this is the seventh post from me on this subject, and includes further
lab work.
Gary Hecker RN <heckergs@UCBEH.SAN.UC.EDU> wrote:

>At 02:53 AM 5/11/97 +0000, you wrote:
>>Here's some more thrown out by some brave souls- c'mon, Nurses, just
>>the Medics in the game so far! this is my fourth post in the series..
>>
>Since the first set of questions you answer are mine I just wanted to say
>that If you look at my sig. I AM A NURSE <g>
OK, I sit corrected- I received Mr. Heckler's missive first as a cc to
the ng posting- my ng reader listed two PM's on the ng's first.

>>>Also how many blocks he can walk before needing to rest, and what his sleep
>>>position is.
>>he walks from lamp post to lamp post usuall, and sleeps where he
>>spralls
>>
>Was looking for orthopnea?
yes, prev posted
>>>ASk him if the extremity swelling is new (homeless people often
>>>have swollen feet).
>>he's been hospitalized for same several times, see previous post
>>
>>> I would also go through other HIV risk factor questions.
>>see previous post
>>
>>>Also would want to know if any recent trauma.
>>he has multiple bruises on his arms and legs, as well as excoriated
>>sores. He denies any recent trauma.
>>
>>> Also what his stools and urine look like.
>>"Shit's brown and piss is yellow, ain't it?"
>>>
>Well shit can be tarry or bright red blood, piss can be concentrated/clear
>like water, cloudy  foul smelling, etc
After he has his shower, he obligingly uses the commode for you- UA
pending, stool is dark brown and foul smelling. stool guiac is
strongly positive.
>>>>Question 2: How much can you depend on ....
snip
>>>>
>>>>Question 4: What lab work or tests would you want to have ready to
>>>>roll by the time the doc gets there?
>>>
>>>Blood chemistry ( would get measured osmolality ), CBC with diff, pt/ptt, 12
>>>lead (said before) u/a with micro, urine lytes and measured osmolity, amonia
>>>level, liver enzymes, rectal guiac.
>>I like the measured osmols!
>>others pending
>I'm becoming a big fan of measures osmol, Even if it does not tell you
>anything, its a good academic exercise to share with coworkers
sputum results are now back, and the quality was listed as 4+, with
many wbc's, some rbc's and many gram positive diplocci being noted.
special stains for AFB and parasites are negative.

measured osmols are 240

calculated osmols are left for the student's calculation
ck
Charles S. Krin, DO FAAFP KC5EVN, Member, PGBFH
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"Reckless, Hell! I hit jus' where I was aimin'"
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