▋I ▋Dr. Haru
2025-02-06T12:06:14.000Z 2025-02-07T11:19:49.000Z
▋I ▋▸Prequel Episode 01.

Dear Doctor :
The 31-year-old female had the past history:
. Multiple myeloma ,lambda light chain type, stage III.
. Thoracic spinal 12 compression fracture, status post-vertebroplasty on 19**/10/30.
. Acute kidney injury/Hypercalcemia/Nephrotic range proteinuria.
Responses disabled for others than plurk poster
latest #8
▋I ▋Dr. Haru
2025-02-06T12:06:49.000Z
Then patient still delirium with anxility.
Sincerely need your expertise to medications adjustment.
THANKS a lot!
▋I ▋Dr. Haru
2025-02-06T12:07:08.000Z
【Present Illness】

As the delirium symptoms improved, no signs of restlessness were noted at other times, however, the patient became anxious when near pool or mirrors.
In addition, patients often refuse to eat through a nasogastric tube due to abdominal distension.
▋I ▋Dr. Haru
2025-02-06T12:07:22.000Z
【Mental Status Examination】

Skinny body build
Mildly restricted facial expression
Mildly anxious mood
Hypotalkative, coherent and relevant speech
Persecutory delusion: not detected
Reference delusion: not detected
Auditory hallucination: not detected
Partial insight
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▋I ▋Dr. Haru
2025-02-06T12:08:55.000Z 2025-02-06T12:11:29.000Z
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▋I ▋Dr. Haru
2025-02-06T12:09:05.000Z
Consultation reply
▋I ▋Dr. Haru
2025-02-06T12:09:12.000Z 2025-02-06T12:10:32.000Z
【Re-educative Psychotherapy】

(1)Content discussed:
* No irritability noted recently.
* Poor oral intake.
(2)Technique applied:
* Active listening and empathize the patient.
* Discuss caring strategy.
* Encourage oral intake.
* Emotional support.
* Education about medication and promote medical adherence.
▋I ▋Dr. Haru
2025-02-06T12:09:21.000Z 2025-02-06T12:10:40.000Z
【Suggestions & Interventions】

1. Please go on the evaluation and management of the patient's physical problems.
2. Epathized the patient and care giver.
3. ҉̣̠͍̍̎̋̎̍͢͞─̴̨͇̜̰̱̗̂́̚͝─̴̧͎͌͐́͝─̵̮͍̟͆͢͞─̵̨̙̙̌́̒͞ 0.5# stat. If anxiety level decreased after taking, try training the patient with pool and a mirror.
4. Encourage oral intake.
▋I ▋Dr. Haru
2025-02-06T12:09:29.000Z
Please contact me (73─̴̨͇̜̰̱̗̂́̚͝─҉̢̝̗̈̇͡─҉̢̝̗̈̇͡ ) if any further problem.
Thanks.
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