Rebirth 90: I opened a hospital in Shencheng

Chapter 603 Different Diagnosis of Diarrhea!
"What's the blood pressure, heart rate, and respiratory temperature?" Nie Chen asked.

Zou Jiaqi replied: "101/80! Heart rate 103."

Seeing that Zou Jiaqi answered first, Ai Mingmei didn't make any noise.

"Respiration 21, body temperature 37 degrees 2.

Nie Chen nodded, then put on his gloves and squatted on the ground. He saw that the old man's right knee was covered with gauze. Then he slowly unwrapped the gauze and opened the cloth pad, and he saw the old man's wound.

The old man's entire right leg was congested in the upper [-]s and lower [-]s, with bruising.

Nie Chen took tweezers and pressed around the old man's wound. The old man quickly took a deep breath and was very stubborn without making a sound.

Nie Chen looked up and then asked the old man's son, "What else is wrong with your father?"

"Ah, he has diabetes. It's been more than ten years. What's more, his waist is not good, and his legs are not good. It hasn't been cured after so many days."

Nie Chen nodded.

Turning to look at Ai Meiliang and Zou Jiaqi, he asked, "What tests do you think this patient should do?"

Then explain to the family members: "This is the intern I brought, don't delay your father's treatment, please understand."

"Okay." The family members nodded.

Ai Mingmei frowned, eyes wide open and said: "Doctor Nie, you didn't check anything, you just asked a few questions."

"Well, I think it should be short of a whole blood ion." Zou Jiaqi gritted her teeth and said.

In fact, she wasn't too sure, but she still wanted to speak out, so she couldn't be underestimated by Dr. Nie.

Nie Chen was startled, and asked, "Why?"

"Because the patient's waist is not good and he has been suffering from diabetes for more than ten years, so a blood ion difference is necessary." Zou Jiaqi said.

Nie Chen nodded: "That's almost what it means, but it's not very precise. Go back and write a record, study it repeatedly, and I'll check it in three days."

"Oh." The two women were taken aback, still checking?
Nie Chen said to the nurse next to the bed: "Take the patient to check the blood ion, liver and kidney function, and then quickly test the blood sugar, leave the stool for examination...give a cefdonix sodium skin test."

The bedside nurse repeated it, took notes quickly, and then went to arrange it.

Ai Mingmei and Zou Jiaqi were envious for a while, if only their recording speed was similar to this nurse.

Nie Chen looked at Zhou Xuezhen and said, "Nurse Lin arranged for a bedside electrocardiogram for him, opened a vein to unblock the collaterals, and gave him [-] normal saline."

"Ok!"

"Family? First, take your father to take a film. Ai Mingmei, take it with you. Bring the film back to me."

Ai Mingmei was taken aback, this is the first day of the internship, and the task was assigned?
Although this task is relatively simple, it was arranged by Dr. Nie!

Doesn't this mean that Dr. Nie thinks highly of her?
Secretly delighted, he said to the patient's family: "Come with me."

Zou Jiaqi bit her lip, turned around and glanced at Nie Chen, but she didn't ask the question in her heart, and planned to go back to study by herself at night.

Nie Chen used this time to prescribe antipyretics to a patient with a high fever.

"Doctor, don't you want an infusion?"

Nie Chen shook his head: "No, you don't have to think about transfusions for minor illnesses, it's not good for your body."

"Hey, thank you doctor."

"fine."

At this time, Ai Mingmei came back with the film.

But the patient came back a long time ago, and had been infused with normal saline for more than half an hour.

Nie Chen put the film under the lamp wall and looked at it.

"Compression fracture of the lumbar spine combined with abrasions on the knee."

Zou Jiaqi said, "Doctor Nie, the patient's condition has deteriorated."

"En." Nie Chen nodded thoughtfully.

"Nurse Lin, continue to give antibiotics to Wei Youyang in bed three. He has been diabetic for many years and his wounds are difficult to heal."

"Ok."

Nie Chen wrote the medicine list and handed it to Zhou Xuezhen.

after an hour.

Wei Dawei suddenly ran in front of Nie Chen, grabbed his arm, breathed heavily and said, "Doctor, go and see that my dad is dying."

Nie Chen was stunned, and asked, "Don't worry, just talk slowly about what's going on?"

"My dad is dying. Look, he has diarrhea!"

"Diarrhea is normal." Ai Mingmei interrupted.

Wei Dawei said: "But my dad pulls five or six times an hour!"

"What?"

Nie Chen was shocked and said, "Go, go and have a look."

Several people moved quickly towards the ward. When they arrived at the ward, the patient Wei Youyang's face was pale and his body was weak. He was not as stubborn as when he came just now because he was already extremely depressed.

Nie Chen opened the eyes of the patient Wei Youyang, looked at the whites of the eyes, and asked, "Have you eaten anything yourself?"

"No, they are all from the hospital." Wei Dawei said.

Ai Mingmei and Zou Jiaqi looked at each other in blank dismay.

At this time, Yin Susu brought a male intern over. He and Ai Mingmei were classmates, and they seemed to have a good relationship. The three of them blinked at each other.

"What's the matter, Doctor Nie?" Yin Susu asked.

Nie Chen looked up at her and said, "It's just in time to help with stool culture, flora analysis, and colonoscopy."

Yin Susu nodded and immediately opened the order.

Nie Chen took a stethoscope and listened to the patient Wei Youyang's heart and abdomen.

"The initial diagnosis may be pseudomembranous enteritis." Nie Chen said expressionlessly.

"Pseudomembranous colitis?" Yin Susu was stunned after hearing this.

Nie Chen nodded and said, "Until the test results come out, we can only use the medicine based on experience."

"Start fasting and rehydration from now on to correct electrolyte imbalance and hypoalbuminemia."

"Ok."

At present, every time Nie Chen makes a diagnosis or visits a patient, several people follow behind him.

Ai Meiliang and Zou Qichu were his interns, and Zhou Xuezhen was now his cooperating nurse. Sometimes Lin Xuan would come over to help when she was too busy.

but!

There is a more troublesome thing.

That is, he receives almost five to eight patients every day, and most of them will stay in the emergency room. One person cannot take full care of them and can only take time to come and take a look.

After Zhou Xuezhen finished recording, she went to adjust her medication.

And Nie Chen went to see another patient, about three or ten minutes later.

Zhou Xuezhen found Nie Chen and took back the test report.

Nie Chen took the test sheet, glanced at it and said, "The whole colon is obviously red and swollen, with diffuse superficial erosions, and there are also obvious abscesses and ulcers in the ileum valve and terminal ileum."

"Hey, the worrying thing happened." Nie Chen sighed.

"What's the matter, Doctor Nie?" Ai Mingmei leaned over and asked meanly.

Nie Chen handed them the test sheet and said, "The patient has pseudomembranous colitis, what should I do?"

Ai Meili was confused, Zou Jiaqi frowned and thought about it, hesitatingly saying: "The antibiotics should be stopped in time, uh, if the patient is seriously ill..."

Nie Chen waved his hand and said: "Don't endorse it, this is about treating diseases and saving people! You should use medicine according to the patient's condition. If you endorse the medication, the dose given to the patient will be too large and will have side effects. If the dose is too small, it will not work."

"Yes, Doctor Nie, remember."

Nie Chen shook his head and sighed.

"Doctor Nie, the results of the patient's stool culture are Candida portuguese and fungal enteritis." Zou Jiaqi added.

Nie Chen nodded: "Well, stop all antibiotics immediately. Because his wound never healed, the county hospital was nervous and gave him various antibiotics, which caused imbalance in his intestinal flora. He took oral fluconazole and continued potassium supplementation." Rehydrate.”

"receive."

Zhou Xuezhen nodded in response.

Then Nie Chen turned to Wei Dawei and said, "Don't worry, now that the cause has been found out, your father just needs to rest and he will be fine."

"Oh, okay, thank you doctor, I'm sorry to trouble you." Wei Dawei said politely.

Nie Chen smiled slightly and said, "No trouble, it should."

Ai Mingmei and Zou Jiaqi followed behind Nie Chen, muttering to themselves.

Suddenly, Nie Chen turned around and said to the two, "You don't have to follow me all the time. If there are new patients, you can follow me."

"Oh." Ai Mingmei nodded foolishly.

Interns usually start with the bed. They need to record the patient's body temperature, blood pressure, and blood sugar. When necessary, they also need to perform auxiliary examinations, such as cell analysis, urine routine, electrocardiogram, etc...

Zhou Xueming, one of the last batch of interns in the emergency department, started as a bed follower. His performance was not bad. Although he was a bit slow and timid, he did not cause any mistakes to the hospital.

(End of this chapter)