Jeepluv77

Okay. So I am looking at a couple things. I did quite a bit of research so I may have over thought this. So far I'm looking at digoxin toxicity, potassium deficiency, and dehydration, in that order. Am I on the right track? Any of these could account for her symptoms but the digoxin looks the most suspicious because of it's own side effects(including double vision, hallucinations, confusion) and it's high potential for toxicity when combined with diuretics(HZTC). HZTC can also cause blurred vision on it's own. Do we know if these were all prescribed by the same doctor? Is she using prune juice, bran cereal, or a high fiber diet to maintain gi regularity, which is common in the elderly? All of these can increase the effects of digitalis as can a salt-restricted diet that she may be on for the hypertension. I haven't listed all of my reasons for looking at these disorders as to not waste your time if I'm wrong, but if you have any questions as to my reasons, feel free to ask. Oh, and please let me know if I'm over thinking this. I tend to do that. By the way, my drug info is from The Complete Guide to Prescription and Non-Prescription Drugs(2005 edition) originally published by H. Winter Griffith, M.D. and revised by Stephen Moore, M.D. in case you were wondering.

I love the duck analogy! Y'all are great. And it's nice to know I'm not the only one to feel like this. Not only on the iv's but also on the glib attitude of that proctor. He also said that everyone makes medication errors, etc. I understand that it can happen, but I also feel like I have a duty to do everything in my power for it not to happen on my watch. When I've done my med practicals, I check all med info when I'm setting up, again before I draw it, and again after I draw it. It only takes a few extra seconds and with some it can make the difference between helping my pt and killing them. It's already such a habit that I have a feeling I will have no trouble carrying it over to the field. Thanks again, y'all.

I'm gonna go in with my game face on. That's what I did last semester. Watched a pa draining a huge abcess and started to feel faint. I just took a knee and pretended I was just trying to get a better angle(yes, I continued to watch. figured I'd have to get used to it someday). No ever knew I had an issue with it. Oddly enough, the blown femoral lines and dialysis shunts didn't bother me. So I'm hoping maybe I'll get there and find I really don't have as much an issue as I think I do. Oh, and I'm gonna make sure I've got my vapor rub with me too. Found out the hard way last time.

In my course, we have been taught to c spine in any trauma call. That some can be ruled out but not an mvc, especially with airbag deployment. Even if the pt denies neck/back pain as the adrenaline surge from the crash may mask the pain. I was actually given a scenario like this a couple weeks ago, with pt walking. I took c spine and used a standing backboard. Pt was a & o X3 but I remembered week 1 of my basic training where they said 100+ times c.y.a. so I did. Turns out the scenario called for the pt to be paralyzed from the neck if c spine wasn't used and/or if pt was allowed to sit down. So yeah, I'd use it. If for no other reason than covering my a.

Thank you for helping me out with this. I'm really hoping I can just get in there and do it. I'm pretty sure that after my first successful stick I'll calm down a little. It's just the whole getting that first stick that's killing me. I'm not even gonna think about the fact I have to intubate a live person next semester. Thankfully it'll be in the or under controlled conditions. I'm still nervous though. I think a lot of it too is that there is just so much riding on me being able to do this stuff well, not just do it. I don't want to be a mediocre medic. I want to be the best. I'm a bit of a perfectionist. People keep telling me to let that go, but it just seems so counterintuitive. One medic today told me you aren't really a medic till you kill a pt. If that's true, then I can only hope I'm never really a medic. Just a great pre-hospital als provider. If that makes any sense at all.

You said she thinks it's 1978. She didn't used to be a maid did she? Also, I've heard of a type of amnesia caused by certain brain accidents that will cause a person to repeat the past x amount of time over and over. Could that be it? Also, this is kinda out there, but does she wear glasses? And if so, are they dirty? Does she have cataracts or anything else with her vision that may be leading her to think the floor is dirty when she looks at it?

We are required to tell them we are students, too. They just told us to leave the brand new student part out and let them think we've been at this at least for awhile. I just feel that's still a lie to omit the fact that I've never stuck a human. I'm actually a hard stick despite being skinny with huge veins. I've got valves like you wouldn't believe. Therefore, I fully intend to listen to everything they say. I've had a lot of nurses think they know more than me and miss the iv over and over. Or try to thread through the valve which hurts really bad and has actually caused phlebitis all the way up my forearm. I think that's part of my fears too. I really don't want to hurt a patient.

That's what I'm saying. They said we aren't allowed to stick each other. Ridiculous. A friend offered to let me stick her but of course I don't have any needles here. There's no way I'm gonna take one from school. But yeah, I don't think that's fair to the patient. We've also been advised by a couple proctors not to let a patient know that we are new students, especially not our first stick. But I feel they have a right to know and make the decision on whether or not they want us to do it. Any thoughts on that? I just know if I was that pt and they missed the iv and then I find out they are this new I'd be furious that I wasn't informed.

Thank you! I'm trying. I don't know why I'm so nervous. I'm usually not like this. The woman that's precepting my shift <cough> isn't the nicest sometimes either so that doesn't help. Nope Scott. It's straight to the er. We've stuck a few dummy arms but that's about it.

So, please tell me I'm not the only one to have gone through this. I've got my first day of als clinicals on the 14th and as excited as I am, I'm freaking out. I'm absolutely petrified of having to stick a patient, administer a potentially dangerous drug, etc. At first I was so confident, I've been doing great in my practicals. As soon as I saw the clinical schedule was up something changed. Now I'm a nervous wreak. I so hope this gets easier. I know that I know my stuff(at least what we've been taught to date) but I can not get past the fear of messing up with a patient. Like missing an iv and having to start it again. Any suggestions? Will I get used to this at some point?

I just got my Basic last semester and just finished intro to als yesterday, so I'm really not sure. I would have to consult medical direction, manage anything that changes with vitals, and transport for observation/treatment. His vitals aren't that bad, but I know they could deteriorate.

Unusual lethargy is a rare but possible side effect with zocor. Am I at least on the right track?

What supplement, vitamins, etc?

When were his last liver panels done? Any chance of impairment leading to a build up of the medication(s)? Has he ingested anything that does/may contain grapefruit juice? How long after taking the meds did this happen? Is he taking any supplements, vitamins, or non-prescription meds? Does he drink? How has he been feeling lately?