Rituxan Reflective Report

Medical History: A 57-year-old Caucasian male, with a history of end-stage renal disease, secondary to biopsy proven IgA nephropathy, history of liver cirrhosis secondary to alcohol abuse, hypertension, thrombocytopenia, leukopenia, who presented for evaluation for candidacy for a kidney transplant. The patient was evaluated at Tampa General Hospital. He went through a full medical work up. He was not listed due to lack of financial clearance per their center.

This cancer of the lymph nodes starts by destroying the cells apart of the body’s immune system and can be deadly. The 10 year survival rate for this cancer is 59% and requires years of therapy for recovery. When Kate first discovered she was sick, she had to undergo severe chemotherapy that has severely damaged her Kidney. She is currently doing dialysis to try and restore her damaged kidney, but only time will tell if she will need partial removal of her kidney or a complete transplant. When she is not in the hospital herself, she’s checking other patients in. Due to health care needs, Kimball currently works weekends as a receptionist at the Tallahassee Memorial Emergency Center.

Haughey says he called the Medical Oncology department and told them to discontinue the chemo therapy drugs. The treatment was stopped for one round, and then continued at the direction of the medical oncology unit. Two to three weeks later, the patient was having problems tolerating the chemo treatment and was vomiting. He was admitted and developed bleeding. Haughey was called almost 36 hours after the patient was admitted, and the bleeding started. By the time Haughey became aware of the issues, the patient had

This simulation was the most challenging for me thus far. During this simulation, what resonated with me most was the importance of prioritizing and patient education. In order to successfully complete this VSIM I had to ask the patient how she was breathing despite seeing the 02 level rise and I also decided to give her a breathing mask before giving her an incentive spirometer to encourage her to cough, which in hindsight was common sense. It was surprising to find out this patient smokes even though she has a history of respiratory issues. I imagine that in a real life situation she would receive some patient education about the dangers of smoking and maybe patches to help quit. Overall, I enjoyed this VSIM because I had to correct a lot

These are the three bills that reference the days I got my treatment. I'm not going to say I'm in remission. That's not going to be the case until my numbers have normalized and that's the word that was used to me. I have more tests coming up in two months. I go back every 90 days. I don't get a scan every 90 days but I get blood work done every

Chemotherapy takes precedence over everything else in our lives. How do we cope ? R. S Gwynn presents a popular coping mechanism in his parody of Edgar Allen’s poem “The Bells.” Gwynn masterfully writes, “You may take the pledge, abstaining, thinking you can lick it all./But it’s hard when, ascertaining how diversions many enthrall,/ You’re still standing there draining one well past the final call:/ How it shows, shows, shows” (13-16). Gwynn’s use of rhythm, meter, and rhyme come together showing how abstaining from alcohol does not hold up against the treatment of cancer. Going through chemotherapy is like a roller coaster. Fighting against the monster looks likes it working, but ha, quickly a diversion, a new medical concern such as fungus in the lungs, seeps into the situation. When the chemo is not killing the cancer, when the bone marrow transplant is side-railed by fungus, wine

To date, Patient C has had approximately 91 IVIG treatments, 6 rounds of chemotherapy, 5 years worth of steroid shots, 9 spinal taps, numerous x-ray swallow studies, CT scans, and MIBG scans, and he just finished having his 3rd porta catheter placed (S. Berkley, personal communication, December 1,

2014 AHA/ACC/HRS Guideline for the management of patients with atrial fibrillation recommends a dose of 15 mg of rivaroxaban daily with the evening meal for treatment of nonvalvular atrial fibrillation in patients with renal impairment (CrCL 15 – 50 mL/min).

In a given situation, Joan is found to diagnose with HIV in 1992. She is 46-year old African American woman. However, the situation got worsened in 2004, when the t-cells went below 200. She is already a Medi-Cal recipient. To overcome her present problems, she prescribed with anti-viral medications. But, she never takes her medication as prescribed, there is a need to provide therapeutic interventions. Later on, she was hospitalized in 2009, where she was also diagnosed with cirrhosis of the liver. There were even observations noted down of declining kidney function. Since Joan was not taking medications on time; the condition got worse. It was later on,

4- Was the transplant given for recurrent PB or one time occurrence with other signs of failed Fontan.

Looking back at my original pre-rotation expectations, for the most part I was not surprised at the activities I was allowed to participate in. I was surprised that my preceptor allowed me to enter into the chemotherapy IV room because of how dangerous chemotherapy medications can be. After entering the room, I was very surprised that there were so many different drug used as chemotherapy for cancer patients. Before I started rotations, I thought that hospital pharmacies bought all their medications in pre-packaged unit doses or a company packaged the medications for the pharmacy. During my rotations I was allowed to help with preparing IV bags for the pharmacist to verify before being sent to the patient, filling medications for the patients, delivering medications to the floors, prepackage medications, and go on rounds with the clinical pharmacist.

Treatments are a huge part of getting back on the right track. Some treatments are harder than others but in the end, many will get to the right place. One of the

During my student teaching experience and my first year of teaching, I noticed that many students struggled to coherently write about their results or conclusions at the end of a lab. Therefore, during my second year of teaching, to help my students strengthen their writing skills, I decided to incorporate a few lessons on the procedures of writing a lab report. Once we had covered the essential parts of the “Scientific Method,” we segwayed into discussing the importance of lab reports in the real-world. We talked about how scientists use them to communicate results, as well as discussed how writing them would develop and sharpen my student’s scientific inquiry skills and scientific thinking. Initially, writing a lab report is a very

Treatments are a long process, depending on what stage you’re in will indicate how long your treatment may take.

The second option to explore would be continuing the dialysis treatments. While considering this option with the family it is very important to stress the hardships that go along with the aggressive treatment. Making the family fully aware of the