I Can See Health

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

Lu Chen quickly walked to the ward where bed 12 was located.

At this time, the time has reached nine o'clock in the evening.

It was dark outside, but the lights were brightly lit in the ward.

She pushed the electrocardiograph 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 depressed spirit.

Lu Chen looked at the health value above her head, which was red at 51!

Another patient with a health value below 60!

…

I saw Lu Chen walking into the ward.

Min Ling turned around and said, "Did you send the patient to the ICU safely?"

"Yeah." Lu Chen nodded.

The patient was delivered safely, but we don’t know how long he can survive.

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

"Received." Lu Chen nodded.

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

…

Next to the hospital bed, there was a middle-aged man in his forties, who must be the girl's father.

"Classmate, are you feeling uncomfortable?"

Lu Chen walked to the hospital bed and asked softly.

The girl didn't reply. She was still lying on the bed, turned over, and faced Lu Chen with her back.

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

In the rebellious stage 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 recently. These symptoms have worsened tonight. Her limbs are weak and she can't even walk, so she hurried to the hospital."

Dizziness, fatigue?

Weak limbs?

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

"Done." The middle-aged man took out two test sheets.

Lu Chen reached out and took it.

The first one is a blood test, nothing abnormal.

The second picture is a biochemical series, showing normal liver and kidney function.

However, the potassium ions in the electrolyte are only 2.1mmol/L.

This is severe hypokalemia!

Potassium is the main cation that maintains cellular physiological activity and is essential for maintaining the normal functioning of nerve and muscle cells, including cardiomyocytes.

Under normal circumstances, the serum 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. In severe cases, unpredictable risk factors such as dyspnea, arrhythmia, and even sudden death may occur.

No wonder girls feel dizzy, weak, and have weakness in their limbs.

With potassium ions so low, it would be 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 lately?" Lu Chen asked.

"It's not bad. It's about the same amount of food as before."

The amount of food intake has not changed, which means that the first reason is not the intake of too little.

"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 causes, you can only rely on further tests and inspections.

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

Looking at her like this, an electrocardiogram couldn't be done.

Lu Chen had no choice but to give up.

"Family members, please come out with me."

There are many questions that are not easy to ask in front of a girl.

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

"Has her character always been like this?" Lu Chen asked doubtfully.

Although he is in the rebellious stage at his age, he is not so resistant to the doctor's consultation and examination.

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

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

"Have you entered the period of youth rebellion?" Lu Chen asked doubtfully.

"Yes, and it's more serious. She has a tendency to be depressed." The middle-aged man said, "I took 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 suffers from depression.

It's like a clear sky thousands of miles away, suddenly dark clouds appear, and you don't know when it will clear up.

"She has symptoms of dizziness and fatigue. How long has she been suffering from?"

"About half a year."

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

Could it be chronic hypokalemia?

"Did you take any special food or medicine?"

The middle-aged man was stunned for a moment, recalled something, and then shook his head.

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

…

Back to the doctor's office.

Min Ling has completed all the patient's medical orders.

"Well, I'm back. What's the disease?"

Lu Chen sat next to Min Ling, paused for a while, and then said.

"The cause of hypokalemia remains to be investigated. As for the cause, there is currently no clue. 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 will bring the medical records over later. After reading them, we can write down the course of the disease."

"Okay." Lu Chen nodded.

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

"Treat the symptoms for the time being and supplement the potassium." Min Ling said, "I asked her to drink three bottles of potassium chloride first, and then intravenously supplemented the potassium at the same time."

Lu Chen had learned about potassium supplementation measures during his internship, but he was not professional.

He clicked on the medical order system and carefully checked the medical orders given by Min Ling.

"Teacher Min, when it comes to clinical potassium supplementation, is oral administration the first choice?"

Lu Chen said doubtfully.

"Well, intravenous potassium supplementation has speed and concentration limitations." Min Ling said, "Oral potassium supplementation, direct oral administration of potassium chloride oral solution or injection, there are no major restrictions, but there is some gastrointestinal irritation. Usually we Dilute with juice and milk."

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

A good memory is worse than a bad pen.

Many clinical things are not found in internal medicine books.

Such as potassium supplementation.

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

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

Lu Chen was stunned for a moment, then replied: "In my heart."

"Oh, in my heart." Min Ling nodded, "No wonder you didn't panic when you just met such a critical patient. You guys have seen a lot. How many studies have you done this year?"

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

"Kan Yi." Lu Chen said.

"You're just studying for the first year?" Min Ling looked at Lu Chen in surprise, "I thought you were studying for the second or third year."

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

I didn’t expect it to be a new student.

"By the way, which endocrinology teacher group are you in? Why haven't I seen you?" Min Ling asked strangely.

Lu Chen touched his nose and said, "Teacher, I work the night shift for a friend. He has something to do and he can't come."

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

"No."

"Then I'll switch to endocrinology. UU Reading www.uukanshu.net can come to our group."

Lu Chen was stunned. Wasn't it assigned by the teaching secretary?

"Don't want to?"

"No, I am willing." Lu Chen nodded quickly.

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

She is the teaching secretary of the Department of Endocrinology.

After encountering such a good prospect in advance, of course she had to stay in her own group, so that she could feel much more relaxed at ordinary times.

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

Lu Chen hasn't come to the endocrinology department yet, but he has already been booked!

…

"Ding ding..."

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

"Is the night shift in the endocrinology department okay? Are you already sleeping?"

Lu Chen remembered that it was Zhou Wei who said that the night shift in endocrinology was better.

He quickly replied to a WeChat message.

"You said the night shift in the endocrinology department is easy to work on?"

Zhou Wei, who was lying on the bed and getting ready to sleep, received the reply and raised his eyebrows, Lu Chen, isn't he still asleep?

"Yes, I worked three night shifts, and every night shift was almost peaceful. Once, a patient had hypoglycemia. I asked him to take a candy and he was fine."

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

"That's because you have a bad face!" Zhou Wei chuckled, and then quickly replied to a WeChat message, "There are four areas of endocrinology, and each area takes turns to admit patients. There are very few patients in the night shift, so the chance of admitting patients is very low. Very low.”

Lu Chen's brows furrowed into the character "Chuan". Is it because I have a dark face?