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08/02/2009 ReplyWDL很冷清了……
我选择在这里回答你,是不希望别人看到之后猜想什么
我很死心塌地地爱你,请你不要把我少找你认为是我不喜欢你
我之所以这样做是因为我认为每个人都应该有自己最起码的私隐
总会有些东西是我不应该看到的,既然这样,我应该让你好好HANDLE……
我不想看见你具体的处理过程,我只要看到处理的结果就可以了~
而且,再多的电话,再多的短信,也永远代替不了见面
既然如此,何不好好把握自己的时间,然后腾出点时间来相见?
你忍不了,可以对我发火
但我希望你可以明白我这样做的原因
我很明白距离是杀手
但既然暂时分开基本上是必然,何不现在就考验一下我们的关系?
毕竟一年时间尚短,出现了问题还可以弥补
要是这一年我依然留在广州,可能的结果只有两个:
一是大家都没有认真实习,学到的东西少之又少……
二是其中一个认真实习了,然后在同一个城市里见面的机会比在不同城市里见面的机会多不了多少,感觉依然痛苦……
相信对于我和你这样的超我型组合,第一种情况出现的可能性基本为零
距离把我的上一段感情杀了
无论我对它的看法和态度是如何,我会坚决地守护现在我和你之间的感情
无论风雨疾病以及何种困难
小康的物质是甜蜜爱情的基础
基础意味着是必要条件,不是充分条件
我没有大志,我只是希望以后一家人可以衣食无忧偶尔奢侈而已……
如果你觉得我比他好不了多少,那是你的自由,我不会介意(要是我介意了,那我应该是那种每个小时都要你发短信给我报到的人)
只是希望你可以把眼光放开一点,看到自己在我身上得到了什么
我不是圣人,不能完完全全满足你所有要求
但我会尽力去改变
P.S. Your affection to me remains despite the corresponding passage of this reply 26/08/2008 一年……偶然间打开了自己的SPACES,发觉上一篇更新已经是一年前的九月十四
离开SPACES,是因为它老不争气的访问速度,也是因为自己老不争气的懒惰性格……
最近Qzone也没有多少更新,就顺水推舟把08年暑假第一篇也很可能是最后一篇日志奉献给冷清的SPACES吧~
一年前,多了一个陪伴自己的丝
缘分这东西很微妙,我选中她纯属偶然,她看上我估计也是意外
猪朋狗友有意无意的提及和那一场突如其来的大雨,无意中写成的肥猪与丝的爱情故事
其实,若非当时心血来潮,我是一般不会送伞给女生的,尤其是……
那把伞还是从小泉哪里借回来的~~
一年来,尽管猪场的生活很平淡
但有了中秋晚会的暴力事件、除了考试还是考试的圣诞节、疯狂的张学友演唱会、情人节的爱情巧克力、痛苦的宿舍搬运计划、COUPLES的定情戒指、郁闷的ZJ医院三点一线、梦寐以求的胡迪玩具和暑假的奥运电视迷,其实,猪场也平淡得很刺激
当我渐渐忘却和丝第一次约会的激情时,我就知道,她存在已经变成了我的习惯了
就像每天的吃饭睡觉一样,貌似繁琐,却永远不舍得离开
我也慢慢地,习惯了她洗发水的香味……
当然,猪依然是猪,依然在为“生活小资,偶尔奢侈”的目标忙碌着
然而,现在多了的是一份理解
也许也只有她才能理解我有时不复短信不接电话……
临床的肉猪,要抓紧时间玩抓紧时间睡,才可以保证肉质的鲜美可口
扯得有点到蛋了……
其实大家都在为自己的将来奋斗着而已
她不干预我的梦想,我也不过问她的目标
紧守着这条原则,其实,我们已经达到了最大限度的理解和尊重
她能做到了以往任何一个都做不到的东西,也许这就是她的特点……
说到梦想,不得不提大三这一年
尽管成绩依然平平,科研仍然为零,但自己的目标却越发清晰了
也正是这样,才发现自己距离目标的距离是如此之大!
大四大五也该好好补救补救一下自己的不足了
努力地发挥一中人颓而不费的本色~
其实,国奥的同学们只要有一半这种颓而不费的精神,他们就可以包揽名利财色了
只可惜,烂泥是扶不上柄的
自从初中看见他们的上一代抱了个鸡蛋还吹自己是31名的时候,我就想要是自己能在百年之前看一下裹足们踢入世界杯前八强,估计也瞑目了……
现在看来,很难……
关于刘翔,本猪仅致以最衷心的问候和最深厚的理解
尽管退赛,你也是亚洲英雄!期待你卷土重来!
不过可能韩国某大学教授朴野仁明年就会发表论文,说刘同志其实不是高丽子孙,而且还说,广州在冰河时期就和韩国连在一起,2010年的亚运会其实是在韩国城市举办的……
其实按照网上流传的他们的教科书图片,韩国一共举办了两次奥运会,一次是1988年兽耳奥运会,一次是2008年燕京奥运会……
没办法,谁叫咱祖先伟大,引发了天启宇宙大爆炸……
顺便也提醒一下各位,奥运开幕和闭幕放的是共和国纳税人的血汗礼花
在感叹祖国强盛之余,顺便也留意一下白菜和猪肉什么时候涨得比1G的U盘还贵
还有那无边草原一般的股市……
做完愤愤了,最后做一轮小资
上星期六有幸去参加讨论会,到以前的四通大厦50楼吃了一顿自助餐
RMB198 per capita外加服务费的价钱,除了可以俯瞰全市夜景之外几乎一无是处
而且,绝对不是医生的好去处:临床一线的战士们吃饭可是除了名的快
经粗略估计,它那里出一个Pasta的速度我可以吃四轮,主任跟夸张,说自己至少可以吃六轮……
所以,据在场人士权威指导:“唔系富婆请都唔好去啊!”
当然了,强调情调的人士可以去尝试一下,毕竟如此近地俯瞰佛山夜景,还是有很大的观赏价值的……
星期一HL破天荒请喝早茶,本猪早早起床不惜牺牲(一部分)色相和她步行至金城占座
5个人5小时(10:30 a.m. - 3:30 p.m.)消费共125元,平均每人每小时5元,我们把早茶喝成了下午茶
直至部长一手夺走我们的单,我们才依依不舍地离开
YY依然风趣,洗立除了搞笑还是搞笑,两位在上海陪我吃喝玩乐四天的大恩人和我
平均每人连续地说话5小时,证明了当年把我们这帮吹水狂魔弄在一个班准备高考是如何的不明智~
同时,我们也见证了为什么人人都说茶市是亏本生意的原因
五人聚会中,除了我以外的四人已经是有G之人了
大四的他们都在找学校、写申请、搞推荐信……
感觉到,以后可能真的是离多聚少了
除非,在极端非常理想的状态下,我们都在花旗国相聚……
那时候,可以忽略空气阻力吗? 09/09/2007 SecretFollow the Notes upon the Journey
At First Sight Marks One's Destiney
Once the Voyage Comes to an End
Return Lies within Hasty Keys
The Secret 24/08/2007 课程表....经主人SPACES提醒,发觉下个学期嘅课程表已经面世了。。。。迫不及待DOWN咗一份,打开一睇
晕了。。。。。。。
今晚先同SIMON倾完,觉得读医虽然辛苦,但系冇乜嘢系熬唔到嘅。。。。。
点知未够十二个钟头,我嘅全部自信心又被完完全全摧毁了。。。
发觉原来读医同逼上梁山真系一D区别都冇,最后都系绝路一条。。。
于此奉劝各位有心立志读医但系仲未做得出嘅师弟师妹:
读医唔系害人就系害己。。。。。
呵呵~~突然间发觉呢句话好有哲理添~~~
正题讲完啦,讲下D其他无聊嘢
第一件:
话说今日中午落去楼下食拉面,同一位靓女搭台
突然间,小店来咗一位单吊猥亵男(廿一世纪仲系左耳夹一支烟,怎一个“捞”字了得~)
短短嘅三分钟之间,竟然可以将小店里边所有嘅靓女搭讪一翻(当然包括我对面果位靓女啦~)
其搭讪之功力可谓有如江水奔奔,早泄入海~~
小弟实在佩服佩服~
不过离谱咗少少嘅系
佢搭讪嘅形式比较单调:
第一句:“你在附近工作吗?”
第二句:“好多次都看见你在这里吃面了,你没留意而已”
第三句:“是啊”
令我不解嘅系,点解个个靓女们D应对竟然都系咁单一!
角色代入一下。。。假如我系靓女,俾佢搭讪。。。
第一句,唔应。。。第二句,都唔应。。。。第三句,摞个火机,点着佢支烟,然后向住佢人中督落去!
食面啊啦!!!(稍微加咗少少个人感情,因为猥亵男搭讪嘅时候竟然拍我膊头示意要我让位。。。碍于着住一中校服裤,冇一只碗车落去个头度。。。朕决定星期六开始日日中午落去食面!望死你!)
第二件:
今晚唔知点解,成条湖景路突然停电。。。
报咗案捻住打俾小强热线摞报料奖嘅时候又突然有翻电。。。。
供电D叔叔做嘢真系快手。。。(当然包括收电费啦~~)
留意到原来全条路嘅路灯一起着系几咁壮观
同时,一黑一白对比之下,发觉当初搬离闹市嘅愿望已经落空。。。。
仲要听讲,明年花市搬去我地果头。。。。
OH YEAH~~同志们一于行完花街就来我屋企打牌直落通宵~~~
第三件:
寻晚同靓靓靓女徒弟去咗睇《合约情人》
笑到肚痛。。。。。
原来叫系可以叫烂个丹田嘅。。。上课一定要同老师讨论下。。。
第四件:
大象翻来了。。。肥强却走人了。。。。
今个假期D聚会真系。。。少啊。。。。
当我响应国家建设节约型社会嘅号召而唔去旅游嘅时候,呢两条肥佬竟然一个去拉萨一个下南洋。。。。
睇来国家嘅号召都系口号~大声嗌两嘢就当系响应咗了~~
第五件:
睇咗《老港正传》,发觉郑中基原来咁好戏,莫文蔚原来咁靓女,毛舜筠D演技原来咁出神入化
网评话呢出戏媚党,但系我个人认为系香港左派嘅真实反映
系较右嘅政治潮流下,仲允许左派游行示威情愿,而且有合法组织,正好反映咗呢个城市嘅包容。。。
赵良骏媚党是假,宣传是真。。。
DOWN咗30集《走向共和》来睇
张黎嘅手法更加惊人
尽力还原历史嘅同时,竟然有对人物性格咁细致嘅刻画
树人哥哥怒其不争讲咗成百年,还不如张导十分钟嘅菲林。。。
时代在进步啊~~~
另外一个张导要学下嘢啦~唔好搞到人地霍叔叔将成间屋都要换成金色~ 18/08/2007 七班·一中七班 四百多个嘻嘻哈哈地奋斗的日夜 班房变了 以前天空白与蓝的颜色亦不复存在 不变的是老师的絮叨 还有一个个依然打扮成高中生的大学生 一中依然 很美丽,很安静 钟楼、地道、生化楼、烂苹果、棺材巷,还有那至少说了30年的鬼故事…… 古老而静谧的校园总能让青春躁动的心平静下来 却永远不会忘记自己的雄心和理想 一中之所以吸引 是因为她有一个自由的舞台 而台下的观众总是带着平静的心和赞赏的目光 什么时候,奋进的廿一班也能聚一聚…… 13/08/2007 12与13的交界上天使•糖
天使给了我一颗糖
一切都好突然
我不情愿地吃了
好像有点 不喜欢
天使给了我一颗糖
感觉不听使唤
我犹豫地吃了
渐渐地 找不到方向
天使给了我一颗糖
有点情迷意乱
我慢慢地吃了
出现了 轻微的症状
天使给了我一颗糖
情愿心甘
我微笑地吃了
看清楚 幸福的模样
幸福的猪
背着快乐的主人
在童话般的猪场中
生活着
幸福可以酝酿
也可以
来得很唐突
只想捉紧眼前的幸福
不想让祂再飞走了
Upon the love pedestal
faithfully I build thy 'castle
It shall be flying in the celestial
Thy be my angel...
Love's beautiful... so beautiful...
多庆幸我是我...被你疼爱的我... 30/07/2007 窗台拉开了窗帘
原来 小区的夜色也可以很美丽
夜已深 美丽不免罩上了寂静
曾经喧闹的游乐园
早已随小朋友入梦
只剩下 蜡黄的灯
厌倦了繁华与喧闹的灵魂
也只能 在这个只属于他的窗台上
沉寂……冥想……
放假,书桌被母亲大人强行霸占
我的空间,就只剩下角落的窗台
撩有学问地把资料和手提放在这里
其实,是因为这个位置WIFI比较快~
明天又得穿上白衣戴上眼镜撩有学问地去见习了
不知道是因为好学,还是因为无聊……
anyway, good luck to myself... and my beloved master~~ 21/07/2007 21te Juli21te Juli....
and it has been 4 years....
it was like a blink
but the path proved no easy...
21te Juli....
a date was to be remembered...
story collapsed
and it now ought to be forgotten...
21te Juli....
was a sweetest day...
but how comes
currently it is a day of constant rainpours and thunderstorms...
I dont quite dare to look back,
that was a memory stroken in my heart
bleeding
and I was laying there with no attendance nor pity
nor the slightest mercy
my soul evap'
hovering on the ground of flowers littered fiercely with my flesh and blood
looking down at the poor wounded angel...
dead...
'Man is born an angel
until someone cruelly turns him a demon'
He has been reincarcinated....
with an empty hallow in the left chest.
The heart was taken away
distroyed
The corpse walks his way
and he was an angel of passion
...... 15/07/2007 3x3x3连续的炎热过后
上天终于赐与我们少少的雨,薄薄的风,微微的凉意……
来得那么突然……
3x3x3,神气的数字组合
从无到有
我的病理书也终于从头到尾翻了一遍,也顺便活活地啃下了一本习题
照照镜子,忽然明了什么叫恶病质……
深信当年伟大的文学家鲁迅弃医从文,是因为读医考试太多太难了……
心里那块薄得快透明的铭牌上又重新科上了一个人的名字
其实,两个月前,祂的名字就被我科上去了
只是自己一直把铭牌反扣着……
但是,我毕竟能从透明的背面看出点什么
也无谓再骗自己了
希望能开一家摩天轮餐厅
和祂坐到最高,享受一下迷人的灯画
担心的是,那块透明的铭牌是否仍经得起磨挫呢?
双子就是这样的了,软软的皮藏着硬硬的核,实实的骨围着松松的髓……
啊!我是不是看病理看疯了??!!
最后一周了。。。。
in cantonese we say:
顶硬上,鬼叫你穷! 10/07/2007 Restaurant de la RoueRestaurant de la roue
where we dream.
A tea of twosome, a lunch in the sky
or a fantastic eve in the chamber
enjoying the scatter of the light.
In the midair of metropolis,
we are the fliers,
no wings are seen,
nor is this a mere dream.
And I shall tell Domina,
the whole is yours,
so am I. 09/07/2007 Voice in Exhaustion过了一个很美妙的周末
周五晚的搜索,周六的图书馆,周日的华姐生日……
几乎把我体能耗尽
只是,有点后悔了
病理依然毫无进展地停在呼吸系统
微生物更是空白一片
要下决心了!
把悠闲与懒惰都留到放假!
发挥一中人颓而不废特色!
Time to PUSH!Make it a hard PUSH!
脑子一直在想着别人
是时候想想自己的学习了……
要将自己的心锁入平静的盒子里……
All signals are neglected temporarily. Don't get irritated okey?:P 03/07/2007 Burst死CHEAP精!
收钱你就通知得咁快
唔使做早操你就一句声都唔讲!
算咩啊?
咒死你全家啊啦??!!
抵你上课当街当巷俾人叼!
MOTHERFUCKHERTITISUCKERTWOBALLEDBITCH!!
简直就超级无敌咁火啊!! 01/07/2007 Dinner for BechDinner for becholer,
one set of zigzag...
Crusine is served.
Dose for one,
style for one.
Designated for the very taste.
But it tastes numb. 28/06/2007 sum sussum sus
always eat and sleep...
and desire for care, tenderness...
guard me and guide,
be you the designated of my life.
tactile works
hug's better
kiss'd been favourable~
amo reginam meam
quis ist sua?
Guess~~~ 24/06/2007 地铁地铁站
人来人往的地方
缘分,在一刻中出现,闪光,而后离去……
列车进站出站
忙碌的脚步未因回牟而稍作停顿……
我们的缘分迅间升华
在微微一笑中耗尽
没有下次
更无下次的下次……
下一站,广州东站
旅程已近终点……
出站时,她向左走,我向右走…… 22/06/2007 随谈最近好似冇乜动力……
打球整亲手,游水整亲手……十分无语……
寄生虫75分口可谓一个打击……
不过打击得多,基本上都麻痹晒~
厚厚嘅微生物……厚厚嘅病理……厚厚嘅单词……仲有本唔系好厚但系又鬼死咁多字嘅三个代表……
好似,即使疲于奔命,案头上嘅书永远都睇唔完,做唔完……
而梦想,始终原地不动,仲系咁遥远……
只系怀疑,会唔会有一日虚脱于追求梦想嘅路上……
可乐早就饮厌了……
每日早上不得不对住果杯香而不浓,更加一D都唔可口嘅MAXWELL
依家竟然连曾经最爱嘅菊花蜜都觉得淡而无味……
莫非,我真系厌世了??
记得高二果阵,经常中午拉大笨象第出去暴饮暴食
应记嘅云捞,大可以嘅粥同埋糯米鸡,利苑嘅烧肉饭,东方广场行人天桥下边嘅兰州拉面,仲有后尾食食下就冇食嘅味之源嘅拉肠……
即使心情再差,只要出去食翻餐,翻到学校HUP一HUP,就会成个人开心翻晒……
依家,为咗迎接本科教学评估,竟然连小北门个老板都走佬避风头……
大家都系度忙于追寻自己嘅梦想
跑得太快了
梦想依然遥远,却突然间发觉,自己离原点亦都越来越远……
亲人、朋友、曾经嘅最爱……都系度慢慢咁远离……
而梦想嘅追寻者,却系企系中点,唔懂得点样去取舍……
希望以后有机会,可以同以前嘅同学一齐,踩住单车,由一中到松风路嘅应记,坐低食一个云捞……
曾经嘅一切变化太大了……我自己亦都变化太大了……
只系,每当听到佛山电台,我都会好自然咁捻起一个节目
个名叫做“旧爱,仍是最美”…… 21/06/2007 PlayLet's play fair again at general alphabet!
Codon: sibpcuqckbhtmptu
just something classical...
eager to play? 20/06/2007 6.2103.07.21
多完美的乘法
只可惜,故事并不完美……
07.03.05
故事结束了
并非我不想挽留
只是,事不过三……
镜子破了
曾努力尝试着修补
只是,镜子的那一边说:我已经没力气再走下去了
破碎的镜子
划破了双手
鲜血直流……
07.06.21
也许,差一点,我们就手牵手走到第四年
只是……差了一点
是时候重新开始自己的生活了
重新买一面镜子
好好爱惜她
好好保护她
好好爱她…… 16/06/2007 你我她 泳儿多谢SILVIA嘅推荐……
泳儿呢D超级实力派嘅歌手把声简直可以杀死人
而且……呢首歌D歌词真系写得非常好……
曾经相信可以浪漫……
生活在花花世界,想靠商店大厦抛掉种种冰冷
多温柔的你我她,可最后哀伤满街
多失望的你我她……
快乐在我心间哪位糟蹋它?
美丽在我心间哪个领略它?
这个闹市真的没有童话吗?
我要努力忘记孤单……
你我她
泳儿
走到地车中观察
多执迷的你我她 相信可以浪漫 建造花花世界 约个男孩再找晚餐 走到大街中搜查
多失望的你我她 想靠商店大厦 抛掉种种冰冷 这个闹市没有童话 美丽在我心间哪个领略它
同在城内失恋 同样怕 你有过爱人吗 信过爱情吗 可最后哀伤满街 快乐在我心间哪位糟蹋它 同在城内希冀 同样散 几多位失败 多得堆满铜锣湾吗 到最后你我归家 哪个在喊 走到日光中感叹
多温柔的你我她 相信可以浪漫 之后通通冰冷 这个闹市没有童话 美丽在我心间哪个领略它
同在城内失恋 同样怕 你有过爱人吗 信过爱情吗 可最后哀伤满街 快乐在我心间哪位糟蹋它 同在城内希冀 同样散 几多位失败 多得堆满铜锣湾吗 到最后你我归家 哪个在喊 流泪到像个湾
阳光中也会蒸发 到处也在繁忙聚散 我努力忘记孤单 你也尽快放低挣扎 美丽在我心间哪个领略它
同在城内失恋 同样怕 你有过爱人吗 信过爱情吗 可最后哀伤满街 快乐在我心间哪位糟蹋它 同在城内希冀 同样散 几多位失败 多得堆满铜锣湾吗 到最后你我归家 各自在喊 几多个在这刻逛街 想喊 R/C = Current Condition痛苦嘅一个星期零一日……啱啱考完寄生虫,下星期一又要考免疫……两日之内睇一本书再做一本题……从来未试过咁颠……不过可能呢D先叫大学嘅生活啦~临急抱佛脚静鸡鸡咁就成为咗我生活嘅一部分……
上个星期过的无敌痛苦……寄生虫作业、无数篇实验报告、选修课嘅变态作业,仲有果本有一千几题,睇到都想呕嘅题集……啊……点解我咁命苦??!!一捻起人地熬完就放假,我地熬完仲要熬多一个月就搞到我崩溃晒了……小道消息仲要不断传来,话我地放二十日假……OMG!!赔翻D假期俾我!!
考完寄生虫之后,同小谷、小华去咗食宵夜……做翻一晚饱鬼,听日继续搏杀!!
本来捻住自己可以用半个钟写晒选修课D作业……点知揾条题系边就揾咗我一个几钟……莫非……我真系越来越猪?
AND觉得自己D英文写作能力下降得实在太快了……呕咗成个钟先呕咗两个CASE……庆幸嘅系:下个星期六我唔使考六级~~
将两个CASE放上来……老人护理真系一门非常深刻嘅学问……但系,我好似对佢真系唔太感兴趣……
Case in Reducing the Use of Physical Restrain on Older People Mrs. M. was an 87-year-old women admitted to the general medical service via the emergency department with a diagnosis of heart failure. Other diagnoses included diabetes mellitus, glaucoma, hypertension, and hyperlipidemia. She was married and lived with her spouse of 62 years in the nearby community. They had three children, who all resided out of state. Upon admission to the floor, Mrs. M. was noted to have an unsteady gait and she required minimal assistance with transfers. She was mildly forgetful but easily reoriented. She had a peripheral intravenous line, oxygen mask at 40%, and an indwelling urinary catheter. She was admitted to the general unit at 3:00 a.m. after being in the emergency department tar the previous 7 hours. The admitting nurse oriented Mrs. M. to the room and the nurse call system. Her room was farthest from the nurse’s station After assessing Mrs. M. and settling her in the room, the nurse returned to the station to take off the medical orders. Within 10 minutes of leaving the room, the personnel heard a loud crash down the hail. Upon reentering Mrs. M.’s room, the nurse found her lying on the floor, with the IV and the bladder catheter pulled out and the oxygen mask off. The nurse assessed Mrs. M. for injury, transferred her back into the bed, and reoriented her to the hospital. Mrs. M.’s IV and indwelling catheter were reinserted, and she was reminded to leave the mask on. Mrs. M. was able to demonstrate how to call for the nurses. Because she had suffered no harm from the fall, the nurse again left the room and returned to the station, At 6:00 a.m., Mrs. M. again removed her oxygen mask, became confused, and attempted to get up out of bed alone. She fell a second time, and her peripheral IV was again disrupted. At that point, the nurse applied a chest restraint to Mrs. M.
Discussion It should be pointed out at the very beginning that the application of chest restraint to Mrs. M. was inadequate. Mrs. M. was admitted to the hospital due to a diagnosis of heart failure. A chest restraint would, however, limit the stretch of the thorax, aggravating her heart failure and predisposing her to potential respiratory failure. Mrs. M. was also diagnosed with diabetes mellitus, glaucoma, hypertension, and hyperlipidemia. Thus, the application of IV, O2 mask and indwelling urinary catheter was inevitable. But special attention should be pay to if her IV is in her sight, which might potentially embarrass her. Also, the nurse should double-check whether the O2 mask and indwelling urinary catheter were of the right size. Since Mrs. M. required minimal assistance with transfer, her bed should be redistributed to a more proximal room rather than the farthest from the nurse’s station. The condition would also benefit from the presence of her spouse, as he might be able to relieve Mrs. M. and help with daily activities.
Case in Urinary Incontinence in Older Adult C. Sanders is an 80 year old man, widowed for 10 years who is residing in his own home Mr. Sanders had a cholecystectomy when be was 65 and a transurethral resection of the prostate for benign hypertrophy when he was 70. He has been treated for congestive heart failure for the past 5 years, and during the past 3 months, he has been taking 80 milligrams of Lasix each morning. Mr. Sanders has had reduced activity because of his cardiac decompensasion and has experienced loss of strength and mobility for self-care activities. He has particular difficulty with small-motor tasks, including putting on and removing his clothing. He often does not remove his clothing at night and resist changing his clothing more than once or twice a week. Frequently, the home health nurse or aide finds his underwear and trousers wet with urine. His voiding are usually in large amounts. He is a heavy coffee drinker and does not like decaffeinated coffee. Urinalysis revealed that the urine was clear of bacteria and fungi. Mr. Sanders reports that he knows when he has to urinate, but that emptying often comes before he has time to reach the toilet. He states that he has reduced his fluid intake other than toffee in an effort to reduce the need to urinate.
1. What is your provisional diagnosis of UI type? 2. What further assessment data is needed to confirm your diagnosis? 3. What outcomes and treatments would you use to manage the UI and evaluate the effectiveness of your treatment?
1. The UI type of Mr. Sanders is Transient Functional Urine Incontinence. 2. Assessment date include a urinary diary, a test on his ADL, a check of this urinary tract and a total test of his kidney function. 3. The UI of Mr. Sanders has a complex of causes. His history of prostate hypertrophy suggests a urethrogenic cause of UI, even though he is excluded from urethritis. Lasix for the treatment of congestive heart failure is an iatrogenic cause, while his large-amount caffeine intake is a pharmaceutical cause. His reduce of mobility worsens the problem because he is not able to reach the toilet when he needs to void. Treatment includes a restraint on his caffeine intake and behaviour therapies such as schedule toileting, prompted voiding, bladder training and PMEs. Also, the function of his kidney should be assessed and re-evaluated in schedule since congestive heart failure and the periodic application of Lasix may contribute to the potential chronic renal failure whose manifestation is UI from polyuria (polyuria is not significantly demonstrated in this case but may be an outcome of continuous application of Lasix and heavy intake of caffeine). 最近爱上咗泳儿嘅《你我她》……歌词将系下一篇BLOG度发表~ |
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