I can see health

Chapter 82 Is my face black?

After asking the nurse, I learned that the new patient is in bed 12.

Lu Chen walked quickly to the ward where the 12 beds were located.

At this time, it was already nine o'clock in the evening.

It was pitch black outside, and the room was brightly lit.

She pushed the electrocardiogram machine to bed 12.

Lying on the bed was a sixteen or seventeen-year-old girl, half lying on the bed, with an indifferent expression and extremely listless spirit.

Lu Chen looked at the HP on her head, it was 51 in red!

Another patient with health below 60!
……

Seeing Lu Chen walk into the ward.

Min Ling turned around and said, "The patient was safely sent to the ICU?"

"Yes." Lu Chen nodded.

The patient was delivered safely, but it is not known how long it will last.

"Well, very good." Min Ling nodded, "Then you come to see this patient, ask about the medical history, review the electrocardiogram, and then go back and write down the course of the disease."

"Got it." Lu Chen nodded

After Min Ling finished speaking, she went back to the doctor's office.

……

Beside the hospital bed was a middle-aged man in his 40s, who should be the girl's father.

"Student, what's wrong?"

Lu Chen walked to the hospital bed and asked softly.

The girl didn't reply, she was still lying on the bed, turned over, her back was facing Lu Chen.

Lu Chen was most afraid of meeting such a sixteen or seventeen-year-old girl.

In the rebellious period of youth, it is difficult to communicate in depth.

The middle-aged man on the side said in a deep voice: "Doctor, my daughter has been feeling dizzy and weak lately. These symptoms have worsened tonight, her limbs are weak, and she can't even walk, so she rushed to the hospital."

Dizziness, fatigue?
Limb weakness?

"Did you do any tests at the outpatient clinic?" Lu Chen frowned.

"It's done." The middle-aged man took out two test sheets.

Lu Chen reached out and took it.

The first one is a routine blood test with no abnormalities.

The second one is a biochemical series, with normal liver and kidney functions.

But in the electrolyte, the potassium ion is only 2.1mmol/L.

This is severe hypokalemia!
Potassium is the main cation that maintains the physiological activities of cells and is essential for the normal functioning of nerve and muscle cells, including cardiomyocytes.

Under normal circumstances, the blood potassium (potassium ion in the blood) concentration is 3.5~5.5mmol/L.

When blood potassium is less than 3.5mmol/L, the human body may experience weakness, anorexia, nausea, and abdominal distension, and in severe cases, unpredictable risk factors such as dyspnea, arrhythmia, and even sudden death may occur.

No wonder girls feel dizzy, weak, and weak in limbs.

Potassium ions are so low, it's strange if you have strength.

But why is the potassium ion so low?

Lu Chen frowned.

Generally speaking, there are three causes of low potassium.

First, too little intake; second, too much excretion (gastrointestinal tract, kidney); third, metastatic distribution.

"How's her appetite recently?" Lu Chen asked.

"It's not bad, it's about the same size as before."

The appetite has not changed, that is to say, it should not be the first reason, too little intake.

"Do you have any symptoms of nausea or vomiting?" Lu Chen continued to ask.

"No."

Excessive losses from the gastrointestinal tract were also ruled out.

If you want to rule out other reasons, you can only rely on further tests and inspections.

Lu Chen wanted to give the girl a simple physical examination, but she was more resistant, so she gave up.

Looking at her like this, the electrocardiogram can't be done.

Lu Chen had no choice but to give up.

"Family, come out with me."

There are many questions that are difficult to ask in front of a girl.

The middle-aged man followed Lu Chen to the corner of the corridor.

"Has her personality always been like this?" Lu Chen wondered.

Although he is in the rebellious period, he is not so resistant to the doctor's consultation and examination.

"It was okay before, but in the past six months, hey..."

The middle-aged man shook his head slightly, then sighed.

"Have you entered the rebellious youth period?" Lu Chen wondered.

"Yes, and it's quite serious, with a tendency to be depressed." The middle-aged man said, "Take her to see a psychiatrist, and she was diagnosed with moderate depression."

depression?
Lu Chen also sighed slightly in his heart.

Such a young girl suffered from depression.

It's like a thousand miles of clear sky suddenly covered with dark clouds, and you don't know when it will clear up.

"She has symptoms of dizziness and fatigue, how long has it been?"

"Half a year."

"Half a year..." A trace of doubt flashed in Lu Chen's eyes.

Is it chronic hypokalemia?
"Did you take any special food or medicine?"

The middle-aged man froze for a moment, thought about it, and then shook his head.

Lu Chen asked some details again, and the middle-aged man responded one by one.

……

Go back to the doctor's office.

Min Ling has finished prescribing all the doctor's orders for the patient.

"Well, I'm back, thinking about what kind of disease it is?"

Sitting beside Min Ling, Lu Chen paused for a while before speaking.

"The cause of the hypokalemia is yet to be investigated. As for the cause, there is no clue yet. In addition, the patient also has moderate depression."

Min Ling nodded.

"The patient was admitted to a lower-level hospital two months ago. Hypokalemia was also diagnosed at that time, but no cause was found."

"Her family members will bring over the medical records later. After reading them, write down the medical history."

"Okay." Lu Chen nodded.

If hypokalemia has been diagnosed before, it will definitely improve the examination related to hypokalemia.

"For the time being, treat the symptoms first and replenish the potassium." Min Ling said, "I asked her to drink three potassium chloride first, and then intravenous potassium supplements at the same time."

Regarding potassium supplementation measures, Lu Chen has learned in practice, but he is not professional.

He clicked on the doctor's order system and carefully checked the doctor's order given by Min Ling.

"Mr. Min, is the first choice for potassium supplementation in clinical practice?"

Lu Chen wondered.

"Well, there are speed and concentration restrictions on intravenous potassium supplementation." Min Ling said, "Potassium supplementation by mouth, direct oral administration of potassium chloride oral liquid or injection, there are no major restrictions, but there are some gastrointestinal stimulating effects, usually we all Dilute with fruit juice and milk."

Lu Chen was taking notes while listening to Min Ling's explanation.

A good memory is not as good as a bad writing.

Many clinical things are not found in internal medicine books.

Such as potassium supplementation.

In clinical practice, "potassium chloride injection" is often taken orally directly, which is the most effective way to supplement potassium, but there is no mention in the internal medicine books.

"Xiao Lu, which department are you a graduate student?" Min Ling asked suddenly.

Lu Chen was taken aback for a moment, and then replied, "In my heart."

"Oh, in my heart." Min Ling nodded, "No wonder you didn't rush when you met such a critical patient just now. You have seen a lot. How long have you studied this year?"

The Department of Cardiology is the most critical department among all internal medicine departments. Patients may have facial changes at any time, and the risk of sudden death is extremely high.

"Yanyi." Lu Chen said.

"Only the first year?" Min Ling looked at Lu Chen in surprise, "I thought you were in the second or third year."

Seeing Lu Chen calmly deal with the patient's condition, Min Ling felt that he should have been in the clinic for a long time.

Unexpectedly, it was a new student.

"By the way, which teacher group do you belong to in endocrinology? Why haven't I met you?" Min Ling asked strangely.

Lu Chen rubbed his nose, "Teacher, I'm taking the night shift for a friend, and he can't come because he has something to do."

"Oh, no wonder I always feel like I haven't seen you in the department. You haven't rotated into endocrinology yet, have you?"

"No."

"Then the rotation will be transferred to endocrinology, you can come to our group."

Lu Chen was taken aback. Isn't the group divided by the secret?

"Don't want to?"

"No, yes." Lu Chen nodded quickly.

"That's fine." Min Ling smiled slightly.

She is the teaching secretary of the Department of Endocrinology.

Meeting such a good seed in advance, of course she has to stay in her group, so that she can relax a lot.

For these attending doctors, there is no resident physician in the department, so having a handy graduate student or regular trainee student can be of great help!

Lu Chen hasn't come to the endocrinology department yet, but it's already booked!

……

"Ding ding..."

The phone vibrated suddenly, and Lu Chen received Zhou Wei's WeChat.

"The night shift in the endocrinology department is okay, are you already sleeping?"

Lu Chen remembered, it was Zhou Wei who said that the night shift of endocrine is good.

He quickly replied a WeChat message.

"You said, the night shift in the Department of Endocrinology is easy to work?"

Zhou Wei, who was lying on the bed and about to go to bed, received the reply letter, his brows raised, Lu Chen is still awake?
"That's right. I worked three night shifts, and almost every night shift was safe. Once, a patient had hypoglycemia. Let him eat a piece of candy, and he'll be fine."

"But I have already pushed a patient to the ICU, and a very serious patient came..."

"That's your black face!" Zhou Wei smiled, and then quickly replied a WeChat message, "There are four departments of endocrinology, and each department takes patients in turns. There are very few patients on night shifts, so the probability of taking patients is very low. Very low."

Lu Chen's brows frowned into a "Chuan", is it my face that is dark?
　Thank you for the rewards of Yeyeyueyuan, whether it is the Three Kingdoms, and 2020083.

　　
　
(End of this chapter)