"Has she undergone a thyroid function test?"
Sigh. The patient’s daughter was taken aback by Xie Wanying’s sudden question, left only in confusion.
Certain endemic diseases, usually not perceived as particularly life-threatening by most people, are often neglected in terms of self-inspection and awareness among the local populace. Few people heed the warnings issued by the national health departnt to local dical institutions. It must be said that, at this stage, cultivating national health awareness requires ti. It’s only when so patients reach a critical condition and are hospitalized for examination, do they realize where the problem lies.
Hypothyroidism, commonly known as hypothyroid syndro, is prevalent among the elderly, particularly elderly won, and in iodine-deficient areas. Like heart failure, it belongs to the category of syndros. Hypothyroidism usually presents insidiously, with a long course, and the mild, moderate, and severe symptoms are varied in different patients. Mild cases may present no symptoms, or possibly muscle weakness. Severe cases, like the current elderly lady, could result in heart failure.
Xie Wanying instructed the nurse and the flight attendants, "Change her to a face mask for oxygen intake."
Patients in critical condition have a higher demand for oxygen, and due to the state of hypoxia, they may instinctively start breathing through the mouth to increase oxygen intake. A face mask, unlike a nasal cannula which only supplies oxygen through the nose, can cover both the mouth and nose, which is beneficial for patients breathing through the mouth. The mask covering the patient’s mouth and nose acts as an enclosed space, preventing oxygen from escaping, and can provide a relatively stable oxygen concentration, which is also advantageous for the patient’s oxygen therapy.
The flight attendants went to fetch an oxygen mask. Seeing this, the nurse asked Xie Wanying, "Give an injection?"
Injections were not an option. She is not a licensed physician and does not have prescription authority. Administering dications without authorization can never be done haphazardly; otherwise, the law would not strictly designate who gets prescription authority. Unlike her cousin’s situation, where she communicated beforehand with her senior brother, allowing them to prepare ergency dical orders if necessary.
If dication is not possible, how about giving a bag of glucose or saline? The patient is experiencing heart failure, not fluid loss; on the contrary, heart failure patients must control fluid intake to prevent increasing blood volu, which would add further strain on the heart.
Seeing Xie Wanying shaking her head, Lu Xin sighed in resignation.
In fact, for such patients, even during less dangerous tis, practicing doctors dare not easily administer ergency drugs. Heart disease caused by hypothyroidism is quite different from other types of heart disease, and many cardiac dications must be used with caution. Commonly used cardiotonic drugs like digitalis can easily cause toxicity in such patients.
The current extent of the elderly lady’s heart condition needed further examination.
Putting on the stethoscope, Xie Wanying conducted a cardiorespiratory auscultation on the patient.
The apical impulse shifted toward the left, suspecting signs of Left Ventricular enlargent. When the condition affects the heart’s structure, it is quite serious, and reversing it isn’t easy. The future may require going to a major hospital for major surgery.
Listening more carefully, the patient couldn’t sit still, and her body was forced to lean forward, gasping. Xie Wanying inserted the stethoscope’s head deep inside the patient’s clothing, close to the chest wall, moving from the third and fourth intercostal spaces on the left of the sternum to below the xiphoid process, could clearly hear a scraping high-frequency sound, overriding the heart sounds. This was the pericardial friction rub. The cause of this sound was the inflammation of the pericardial fibrous layer, with the roughened pericardial wall layer rubbing against the visceral pericardial layer on the heart’s surface during cardiac activity.
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