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Week 6. EtOh = Alcohol

In honor of the weekend (and no invisible planet hitting us today), here's a really-quite-serious, "How drunk are you?" quiz based on how pickled your brain feels (loosely adapted from Table 38-1 in Lehne's Pharmacology for Nursing Care, 9th ed.)


1. Increased confidence? Euphoria, decreased inhibitions? Congratulations, the alcohol has reached your frontal lobe. Blood alcohol approximately 0.05%.

2. Loquacious? Judgement altered? Your frontal lobe continues to be affected, and you are now at or past the legal limit of intoxication, 0.08%.

3. Tremors? Involuntary body movements? Reduced attention? Your parietal lobe's been breached. 0.15%.

4. Reduced motor skills? Slurred speech? Parietal lobe conquered at 0.2%.

5. Altered perception? Double vision? The occipital lobe's getting pickled, 0.25%.

6. Altered equilibrium? There goes your cerebellum. 0.3%.

7. Feeling apathetic? Inert? In a stupor? Really shouldn't continue, because you're down to the diencep…
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Week 5. Drsg = dressing

Wounds must heal from the inside out, the ruptured skin one's largest organ.

Wound care: to change dressings, carefully loosen the tape around margins. Moisten if dressings stick during removal, then assess and measure the damage, including size, color of tissue present, amount and type of exudate and color. There may be tunnels, undermining, necrosis, awe-inspiring and terrifying geological formations of the flesh, craters and caverns, deep vale all the way to white bone. Irrigate with 0.9% saline, or tears, if you like.

Actually, no crying into open wounds, because maintaining a sterile field is imperative for healing. Never turn your back, either. Pack gauze, cover, tape, box method.

And if the gruesome, bone-in-the-middle wound doesn't kill one, one's GPS might try to kill her by repeatedly sending her back to the same spot, barking, "turn left," (into oncoming traffic), over and over again. She might survive, but the P. sennae butterflies liquified against h…

Week 4. IM = intramuscular

So many things are skin deep. Beauty, blemishes, piercings, skin itself. An intradermal injection done correctly: bleb on half a hot dog, tiny yellow bubble on the hefty cake of human flesh or adorable meat cupcake. If you were vaccinated for TB as a child, no more skin tests for life. (It's radiation from chest x-rays for you every two years instead.)


Almost always, the vaccination is worth the risk. Protect your child, protect the immunocompromised, achieve herd immunity.

But we can't vaccinate for everything--not the unexpected, the accidental. Sometimes an old ampule explodes in one's hands, all glass shards and beads of blood, a symbol of something specific in one's life shattering into a hundred pieces, embedding tiny crystals in the skin, the clenched towel insufficient to stop the bleed. Sometimes the hurt is too deep, subcutaneous, intramuscular, all the way to the heart. (The heart's mostly muscle, too.)

But it's no use worrying every time an ambulanc…

Week 3. Inj = injection

"Take then thy bond, take thou thy pound of flesh." (Shakespeare, Merchant of Venice 4.1.13) The star of this week: Shylock's pound of flesh, courtesy of Limbs & Things. Half a log cake: rubber epidermal frosting, spongy subcutaneous cake, red muscular filling. Best thing ever because all those injections would have gone into our skin, our flesh. (This time next semester we'll be human pin cushions.) Also great for petting in lap like Dr. Evil's cat.  Pound cat--no claws, slightly sticky to the gloved touch.
Sterile gloves must be opened up and put on in very specific manner. Hands do not go below the waist; keep every finger in sight at all times. Sterile supplies like Foley catheters must be unwrapped, laid out and prepared just so. Lubricate the tip before contaminating one hand holding apart patient's bits. Never cross the sterile field, lean, or talk over it. 1 inch borders all around. 
Do not inflate a balloon in someone's urethra, or what'…

Week 2. ADL = activities of daily living

The humanity of it all:

Nurse squeezing feces out of colostomy bag of depressed young man, and since the bags are not single use, quietly replacing the curved, plastic clip on not-exactly-sterile bag. Embarrassed Grandpa's clip falling out (and everything else along with it) in the middle of a family gathering.

Enemas (four types), sometimes repeated, or raised and lowered like aquarium-cleaning pump, changing the water if too much solid matter appears.

Patient being lifted by hospital's version of a miniature forklift, dangling in gigantic, plastic stork's pouch like a baby again.

How everything comes full cycle, the girl the mother of the woman, the woman mother of the girl. What starts on four legs, goes on two, and ends on four? Same goes for men, and everyone in between.

None of the positions dignified, upsetting for family to see even though positions change every two hours to prevent bedsores (and with them, lawsuits). Fowler's, dependent upon the bend of the ho…

Week 1. Nsg = nursing

8am's a little early to be watching a dick bath on a large projector screen, but one cannot be shy in nursing.

In the afternoon, everyone will give Tiresias, old rubber man with wrinkled dugs and two options for genitalia, a full bed bath. Also, turn him without breaking his leg off and change his bed with him in it, hospital corners and all. Perform oral care, taking extra care with dentures.

We also take one another's pulse, blood pressure, and respiration, and the vitals of the incredible, programmable, $160k, wifi-enabled, anatomically-functioning man-doll hooked up to a monitor in the mock ICU.

In another room, we practice restraining one another, to a wheelchair or hospital bed.
But every one of us is Houndini.

And this happens--twice.
"Ms. Chao, do you remember me?"
Oh no, here it comes.
"I was in your Engl 1A. It was a really long time ago."

One knows one taught community college too long (and hasn't stayed away long enough) when one goes back t…

DNA

DNA, Deoxyribonucleic Acid, blueprint molecules for everything that makes you you. Race/ethnicity isn't a biological thing present in your DNA, however.

There's a lot we don't know about the estimated 20,000 or so genes present on our 23 chromosomes and the simple and complex traits they govern. We do know that genes coding for superficial traits such as skin, hair, and eye color, are just that--superficial. Scientists argue that race (e.g. African, Asian) is a social construct because there aren't genes only present in Africans or only present in Asians and not present in other "races," and there aren't genes present in all members of a particular "race," either. Two people from the same perceived race can be as genetically different as two people from different races.

So there's something insidious about these ancestry sites that analyze your DNA and tell you what percentage you are of which ancestry. What these sites are calling Irish, Eu…