yay i have so many feels already

New Nurse Tips: Lovenox vs. Heparin for DVT Prophylaxis

Nursing school is hard. Anyone who’s been through it knows. Perhaps the general public might not fully understand, but maybe they do, since nursing is once again the most trusted profession in the United States. (Yay team!)

The amount of knowledge thrown at nursing students is so voluminous that many new grads walk away a little shell shocked and wondering if they learned anything at all. 

Originally posted by yourreactiongifs

In fact, I don’t know a single nurse who didn’t feel a little overwhelmed and nervous when they started caring for patients all by their lonesome. In the short time I’ve been a BSN, RN, I’ve already learned stuff, or in many cases, re-learned stuff, that if you’d asked me on the first day of nursing school, I would have just given you a blank stare.

Originally posted by plumkat

Yeah, pretty much exactly like that.

So! Anyway, long story short, as I embark on my second career as a nurse, I thought I might be able to pass along some of the practical knowledge I’ve gained to nursing students and new nurse grads, that may help them in their clinicals and/or roles as RNs.

Our first topic: Enoxaparin (Lovenox) vs. Heparin for DVT prophylaxis

I am an ICU nurse and pretty much every patient in our ICU will be on either Lovenox or Heparin for DVT prophylaxis. There are also SCD’s, but that’s a topic for another day; I’m trying to keep these posts relatively short.

If a patient has hepatic (liver) dysfunction, then most likely, they will not get Lovenox because it is metabolized in the liver. So, if the liver isn’t working, it may not clear the drug resulting in hepatotoxicity.

While Lovenox is metabolized in the liver, it’s primarily cleared through the kidneys. So, if the patient has kidney dysfunction, with no liver issues, they can still receive Lovenox, but at an adjusted dose.

TL;DR: Don’t give Lovenox to patients with liver problems.

Disclaimer: By no means is this a comprehensive analysis of enoxaparin and heparin for DVT prophylaxis. There are numerous other conditions in which cautious use of either would be warranted. The main point of these posts will be to hit the highlights. For example, in this case, if you get a patient on admission and you see they have a past medical history of liver dysfunction/failure, the first thing you should be thinking is, “be on the lookout for hepatotoxic medications.” You see what I’m getting at? I’m sure there are some nurses out there who have cared for patients who received Lovenox even though the patient has a liver dysfunction. That’s fine, but it’s the exception, not the rule.

Congratulations! If you made this far, send me a chat message and I’ll respond with a random fact about myself.

7

GINGA’S AGENTS ARC- Hajime Hikari Pg.8

So, Hajime thus far has been Ginga’s rock after Yumi passed away. Nobody really comforted him as much as he did. So upon hearing Hajime might be leaving his side as his manager, Ginga can’t handle feeling “abandoned” by another person he trusts an sees as a friend. Next page, Hajime reveals why he is leaving and if it will be temporary or forever.

((SORRY THIS TOOK 5 BAJILLION YEARS TO COME OUT! Next page will be released tomorrow! I wanna wrap up the Hajime Arc this week ;w; cuz I love my baby. He is honestly probably ma fave of Ginga’s agents , right up there with Yumi of course ♥))

I want to start my own webcomic! yay... or nay?

Lately I have been thinking about starting webcomic series - I’m following so many great webcomics and I feel inspired by them to start work on my own sometime : >… Well, to be honest I wanted to create something like that almost all my life (and there were some childish attempts to do so), but right now I’m finally starting to feel confident just enough to start to work on something bigger and not feel completely ashamed of it : D
I already have some ideas of characters and plot(since I was thinking about this often), soo, I guess if I wouldn’t be too lazy I will start doing something about it when summer starts(and semester will end, that is more important :´D)… I hope I will feel this inspired even after those two months that are ahead of me, hehe.
Oh, and as usually feel free to tell me your opinion about this, or share links to webcomics that YOU like : )

anonymous asked:

Imagine the non-Christmas celebrating Hausmates searching for an open restaurant on the 25th.

It starts with a smack and a groan. Then, into the howling, frozen night, “I SAID LEAVE ME THE FUCK ALONE!”

Lardo and Dex are on the stairs before the bang! ricochets through the Haus.

“What the hell, man?” Lardo calls out as they race up the stairs. No one answers. They get on the landing to see Adam in front of Bitty’s closed room and Chris peering out of his, slack-jawed.

“Holtz?” Lardo’s voice goes all soft as she pulls him away, but Dex can’t take his eyes off Bitty’s door. Nursey was in there. Nursey was sleeping. Nursey who is the definition of calm and collected…chill. Adam had only wanted to ask if Nursey wanted Chinese or Middle Eastern. It’d been a tie between the four of them without Nursey.

Dex flings the door open and closes it behind him, ignoring Adam’s distressed sound.

Derek’s head snaps up when Dex walks in, his mouth curled in a tight sneer. He doesn’t relax when he sees it’s only Dex. Dex never expected him too, but…things have been better. Between them. He thought his presence might be a comfort to him.

Dex doesn’t know what to say. He doesn’t know what happened. Derek has never…

“I—” he starts. He snaps his mouth shut when Derek stalks towards him in response.

His warm liquid eyes are now steel, are now— “Whatever you’re gonna say, don’t. Just leave me alone. Back off!

Oh, is that how it is. Dex grew up with a big family. Everyone lived in the same town or the town over. Which meant a lot of men, testosterone. Which meant a lot of posturing. Dex learned to hold his own real young, so he matches Derek’s smirk and pushes back. “Not really my style, Malik.” Before Derek can respond, he continues, “you’re coming whether you want it or not. It’s Christmas. Would’ve never taken you for the Grinch.”

Anger snaps through Derek’s eyes and Dex is backed up against the wall before he knows it. He gasps from the sudden movement, not pain, but Derek’s eyes widen nonetheless and he stumbles back, shock filtering through his eyes. His shoulders deflate, shadows in the dark room, and Dex straightens. He counts to twenty, to slow his heartbeat, to even out his breathing. Twenty seconds of silence before Derek grabs his jacket and leaves in a flurry of activity. By the time Dex can respond, the main door slams shut and Dex is pressing small, firm circles into his forehead. What the fuck, Nurse…

“Lardo, you have a car, right? Take Chris and Adam to that Middle Eastern place. Derek and I will meet you there,” he calls out as he shoves his arms through his jacket and grabs enough scarves for the both of them.

“You sure, bro?” Lardo cocks an eyebrow at him.

He smiles because he can tell she’s worried for him. “Yeah! Don’t worry, alright? I’ll drag the Grinch back with me.”


It isn’t hard to track Nursey given the footsteps in the snow, and Dex hurries to catch up with him. He doesn’t know what’s wrong, but it doesn’t matter. They’d agreed to be friends, and this is what friends do. Even when one is being a dick.


Dex finds Nursey on a bench by the river. He’s a speck of black against the white snow blanketing everything around him. Dex pulls out the spare scarf and wraps it around Derek before sitting down.

Any other day, he’d have been fine with just sitting there, waiting for a response, but it’s cold as fuck outside and his balls are gonna fall off if they stay too long, so he starts with the obvious, “you’re being a dick. I don’t know why, but you are. But, like, since this is the first time in a year, I don’t think Adam’s too mad at you. Neither am I.” Dex sighs. “Our team—we’re a family, bro. It really is like I traded in one for another. It means that no one’s gonna leave you alone to sulk. Thought you knew that.”

Time slides past them, the only moving thing in the dead night.

Derek exhales and moves closer to rest his head on Dex’s shoulder. “Why would I? Never really had a family,” Derek mumbles out.

“You have two moms. They love you.” They have to.

Derek shrugs. “I don’t know how. They don’t know me, Will. They—” Derek laughs and it’s ugly and bitter. Dex shifts closer. “I’ve never spent the holidays with them. For as long as I’ve remembered, they’ve done things just right. They tell me they love me, kiss me goodnight and drop me off to school. But I don’t remember the last time I talked to them. Every year, they’d work their asses off to get me expensive clothes, supplies and shoes and then during break, they’d fucking leave me with the maid while they go off and vacation somewhere. I’ve always been alone during the holidays.”

Jesus… “Well, you…you’re not alone anymore.” Dex grabs Derek’s hands in his own and makes him focus. “I’m here. Adam, Chow, Lardo, we’re all here. For you. You don’t have to be alone. Derek, fuck, I’ll spend Christmas with you. Or Hanukkah or whichever. Every year if that’s what it takes for you to never feel alone on Chr—the holidays, okay? Fuck everything else. It’s in the past. Right here, right now, you’re not alone. Okay?”

Derek stares back at him, eyes wide and soft. “O-Okay.”

The kiss is sudden. An instinctive act, really, light and sweet. Dex pulls back before it can become more than a caressing comfort and ignores the way Derek follows.

Clearing his throat and smiling, Dex loops an arm around Derek’s shoulder to pull him up. “Alright then, let’s get the hell outta here. My balls are dying. The others are at the restaurant already.”



ITH Holiday Special 2016 posts

anonymous asked:

How about the companions reaction to the Sole Survivor asking how they feel about settling down and having kids? Becoming a happy little family!

:,D Yay!!! Someone asked me to do the thing. I feel so honored! In terms of the context, I’m going to make them all romanced. Cute prompt! I’m imagining them all holding babies. I hope I do this right

Preston Garvey: He would be so happy his face would turn all red and he couldn’t stop this huge smile from coming to his face as he pulled them in for a long kiss. Hell, he had already been thinking it long before they had asked. Knew how many kids he wanted. Knew their names too.

Danse: He’d be surprised at first, not thinking they would feel the same way as him. He was still not used to this coping with who he was and all but man…could SS make him FEEL. They had traveled through hell and back. Shown him sides of him he didn’t know existed. But this? He had never been happier before in his life. He gladly would take the leap of faith and have a little soldier of their own.

Piper: Oh Blue you make all her dreams come true! They practically were a family already with Nat and all. It all just seemed to fall into place naturally so when SS asked her she didn’t bat an eye. What’s one more to add to their happy family?

Nick Valentine: First he would try to convince SS that what they wanted wouldn’t be an old discarded synth with transplanted memories that weren’t even his own. But SS wants him for the him they see now, not as a memory. He would gently walk down that road with them, hand in hand, until the end of time.

Hancock: Aw Geez…He wasn’t even sure if he could anymore, with him being so irradiated at all. Besides, why would SS want to have a family with his ugly mug? But then they look at him like it is the most sure they have ever been in their life and then all of his worries melt away. SS’s love was the best drug there was. Now time to kick some ass as a family!

MacCready: His eyes would light up like a Christmas Tree! Since Lucy, he had felt like he had failed Duncan and an attempt at a first family. But SS always made him think of the future. This was a miracle! In all the Commonwealth he could not believe he found such an amazing person to share the rest of his life with. Now Duncan would have a sibling!

Deacon: Hesitant at first. He was always on the run, always someone new. Could he truly commit to the forever role of Dad? Many reassuring kisses later, Deacon was already making their little kids clothes so that they could all be matchy-matchy together as a family.

Cait: Oh no, not some sniveling nose little brat. She was very opposed to the idea at first. Kids whined and cried and made life miserable. Why give up the good thing they had by ruining it with kids? They were kicking arse on the road! But like always, SS managed to persuade her with their unconditional love that she felt she didn’t deserve. Little did she know, when that snot nosed little child would soon come, it would be the happiest day of her life.

Curie: A family! Oh she would be overjoyed! She never thought she would get to experience such a thing. Most her life she had been trapped, with a purpose. But now she could take steps of her own! How marvelous! Now she could only ponder at the possibilities of different gene combinations of their kids.

X6-88: Were they not already family? The family was the Institute and SS was its leader, so naturally they were a family. After much explaining, he finally gets what they mean. At first it seems like he is opposed to the idea. Then one day they wake up to copious amounts of baby supplies piled in high in their room. It must have taken a while to collect all of that.

Strong: WHAT IS THIS FAMI-LEE? WHY YOU BRING TINY CRYING HUMAN TO ME? STRONG NO UNDERSTAND! WHAT? IT DRINKS THE MILK OF HUMAN KINDNESS?

Dogmeat: woof! (of COURSE he volunteers to be the first babysitter)

Codsworth: Oh he would be so elated, his whirring machinery could be heard a mile away. He only got to tend to Shaun a few weeks before he was gone, stripping him of the opportunity to practice at a family. (fight me Dogmeat)

3

My first ever weekly spread EVER! Its only two dailys and the weekend though, since I got my bullet journal on Wednesday and May 1st is tomorrow! A new month, yay!!

Gosh, I have only had my studyblr for a week and I am loving the community so much! I cleaned my room, studied for finals, AND went to dinner with some friends tonight because I’ve already learned so many helpful and motivating tips and tricks to getting shit done! Everyone is so kind and such sweeties! I feel like I can do anything, which I can!!

(I was so proud of the tree I drew, even though its very autumn-y and its April right now. But, whatever I like it still!)

Oh, yeah! I’m gonna tag @studypetals because I LOVE HER BLOG WHAT THE HELL - and - there is this contest thingy she is doing that you should check out! (I’m on mobile I can’t link to the contest post, sorrysorry)

anonymous asked:

Not a confession- I often can't help thinking about the influence of the Horcrux on Ron in Book 7- the power of horcruxes and them targeting people. As we know, Ginny literally set a basilisk on student as a result of a trance and influence by a Horcrux. I can't help but wonder what would have happened if Ron hadn't snapped and left when he did and instead stayed in that hostile tense environment still under the locket's influence, what he might have done. I'd be curious to know your thoughts.

I have this conversation a lot! So many people try and use Ron’s actions under the influence of the Horcrux as backup to their ‘disloyal friend’ opinions and Ginny is one of the biggest points against that but I rarely see people making it so YAY YOU! AND YAY RON FEELS.

anyway, that locket was poison. It was PARTICULARLY poisonous to Ron because he was already feeling completely useless in the hunt for horcruxes. 

He was frustrated because Harry had made it seem like he and dumbledore had been working on it enough that Harry wouldn’t have been so lost on his own, and he was doubly frustrated because, well, Harry was the Horcrux hunter. It was his destiny to take down Voldemort. Hermione was the brilliant one, great at magic, great at knowing just what to do, great at keeping a level head, great at everything from Ron’s pov. And Ron was completely and entirely useless, in his own head. He had no idea what just BEING there did for the other two, and he couldn’t help thinking it might be better for everyone if he just went home. They could handle things there and he could keep an eye on his family instead of constantly worrying about them.

The Locket attached to all of that like a demon and amplified it like crazy, it made him almost hate his best friends, it made him hate himself, it made his worry for his family tenfold, it gave him anxious energy. If he had stayed, he might’ve done irreparable damage to his friendships, I’m almost sure of it. Of course Harry and Hermione know it was the locket and not Ron, but even still. If it could make him throw the fact that Harry didn’t have a family in his face, THE ONE THING RON MADE SURE HARRY HAD FROM DAY ONE, the one thing Ron was BEST at, being his family, making him a part of his, writing to him about how he wouldn’t have to deal with the Dursleys much longer pretty much EVERY SUMMER. If it could pull him so deep that he says ‘You wouldn’t understand because you havent got family’??? AND THEN MAKE HIM LEAVE ON TOP OF IT? Ron would never have, he would NEVER have left. He might’ve wallowed in self doubt and worry still, but he would’ve stayed. And they probably would’ve helped him through it. But if it could do that, I feel like that shit could’ve made him do anything. And I truly believe it would’ve eventually turned him against them both completely, if he hadn’t left. And even if he returned to normal after, Harry and Hermione probably wouldn’t see him the same. But I don’t think they would’ve even gotten a chance to try and forgive him for whatever he might’ve done, if the Locket had gotten into him as far as it had with Ginny and he DIDN’T LEAVE;

he probably would’ve murdered them in their sleep. The locket would’ve whispered that he do it, how easy it would be and then he wouldn’t have to deal with being third best to the chosen one and the brightest witch of her age. That he would stop being second best friend to them both. That with such a simple action he would be free of it all. I mean the damn thing nearly drowned Harry WITHOUT draining strength from someone.

Look at the scene where he’s supposed to destroy the horcrux. It is so damn powerful, the scene and the horcrux, its hold on him is so IMMENSE he can barely even destroy it. He is so scared of it and what it did to him that he doesn’t even want Harry to open it, doesn’t think he can manage it. And then theres THIS 

“Do it, Ron!” Harry yelled.

Ron looked toward him, and Harry thought he saw a trace of scarlet in his eyes.

“Ron — ?”  The sword flashed, plunged: Harry threw himself out of the way, there was a clang of metal and a long, drawn-out scream. Harry whirled around, slipping in the snow, wand held ready to defend himself: but there was nothing to fight.

LIKE. If that isn’t some crap to tell you what would’ve went down I don’t know what is. Harry was legitimately terrified for a second. Of Ron. He got up fully prepared to defend himself against his best friend and this effing soul that was screwing him up. He mentioned the red eyes again in the next paragraph too so we know that it was a real thing. 

talk about intense.

(was gonna put under a cut but got a bunch of messages saying not to??? so… okay)

10

HAPPY 21ST BIRTHDAY LEAFYISHERE !


Excuse me for this small birthday greeting. But yay tho god our tol yet smol bean…eh reptilian is 21 years old now or by the time I posted is considering eh my timezone. I’m crying so much, I feel so proud omg. We’ve seen you grow throughout the past years. We your fans, would always love and take care of you ( even if sometimes we may think that you never notice us loool and I still don’t have you to follow me on twitter but that’s alright ) But since you’re twenty one already please don’t do everything all at once. Spread it out — you have many years and hangovers ahead of you! Happy birthday to our  Cyber-Hitler, Faze_ChickenNugget, Lizard Cunt, The Cyberbully, Illuminati Puppet, George W. Bush, and Reptilian King . Hope you all the best, and we love you, dad lol and stay as cute as ever! 

( @leafyyishere )

4

It’s INVISIBLE ILLNESS AWARENESS WEEK! So here are some facts about mine.

It’s a bit long, but it would mean a lot to me if you read it. I think it’s really important to have an idea of what being sick/disabled can look like. There are so many misconceptions about what the life of a person like me is like, or even that we exist at all, so while this is just one perspective I hope it helps expand your idea of what is possible under those labels. I know I had a very narrow and totally wrong view myself before I got sick. So yeah please read, for me and others you know<3

PS: if this is too long, the 1 piece of advice I would give is just BELIEVE what people tell you, don’t think you can determine whether medical info they give makes sense or if they are faking/over exaggerating. Know you probably can’t tell someone’s medical status just by looking or watching them - people are complicated, symptoms vary, a disease is weird and can effect people in unexpected ways

30 Things About My Invisible Illness You May Not Know

1. The illness I live with is: Ehlers Danlos Syndrome (EDS—a genetic connective tissue disease), post concussion syndrome, and several secondary conditions to EDS, including dysautonomia/POTS, cervical instability, and (suspected) mast cell activation syndrome

2. I was diagnosed with it in the year: Misdiagnosed with fibro in 2011, the rest came in 2013-14

3. But I had symptoms since: I started having minor joint issues in 2005, but major problems started in 2010-11

4. The biggest adjustment I’ve had to make is: Oh wow. I had to come up with an entirely different identity and concept for what a good life could look like. I love my life now, and I’m really happy, but it took a while to get there. I used to be an incredibly ambitious person, who was used to performing at a really high level and being busy 24/7. I’ve needed to slow it down & reevaluate what’s really important in life. I think I would have been horrified if you’d told me 10 years ago I would have dropped out of college, but I’m actually totally I’m at peace with where I am. I’ve done a lot of cool things since I’ve been home

5. Most people assume: that my life is tragic …. that one is hard to respond to. They seem so sad when they find out the details, but honestly in a big picture way life is good

6. The hardest part about mornings is: I often feel really sick in the morning because of dysautonomia. So I’ll be faint, nauseous, dizzy … just not at my best!

7. My favorite medical TV show is: Mystery diagnosis! Which I mostly watched while I was still, indeed, a mystery

8. A gadget I couldn’t live without is: My phone/laptop. Because I’m home a lot they are really my lifeline to the world

9. The hardest part about nights is: Probably needing to sleep in a neck brace, especially now that its giving my jaw issues. But it’s so much better than NOT sleeping in a neck brace is for me at this point, so I’ll take it:p

10. Each day I take: I take 14 prescription and over the counter medications, and about 10 more supplements. Almost all of them are considered minor, safe medications (like 5 are for allergies), but still that number adds up!

11. Regarding alternative treatments I: Wish I had time/money for more of them. Massage, acupuncture, and float therapy have all been helpful for pain management

12. If I had to choose between an invisible illness or visible I would choose: I think invisible is easier in many ways ….although I sometimes blur the edges with all the braces I use

13. Regarding working and career: I’m really lucky to have a fantastic part time job I can do from home. No idea what the future holds in this department … a lot of careers I might have chosen seem tricky bc they are too demanding, or the schooling is. So we’ll see

15. The hardest thing to accept about my new reality has been: Sometimes I feel sad about the lost “potential,” and honestly I still don’t like thinking about the kind of things people expected from me when I was younger. I guess I have a small degree of sadness that I’ll never work at a particle accelerator or be a big name in my field or anything, but honestly I might be happier this way:)Definitely less stressed!

16. Something I never thought I could do with my illness that I did was: Be happy! Or even find a life worth living. But I’m actually happier now than I was before I got sick

17. The commercials about my illness: I haven’t seen any yet. I get a couple Facebook ads suggesting I buy electrolyte drinks, but that’s about it

18. Something I really miss doing since I was diagnosed is: I just miss being able to be busy all day. I have so many things I want to do and love doing, and I have so little time for all of them!

19. It was really hard to have to give up: Ballet and flexibility training. I miss stretching so much

20. A new hobby I have taken up since my diagnosis is: running my blogs! I’ve found this really fulfilling and I never would have gotten into this if I hadn’t gotten sick. Its really great to be able to help people, and to realize that something that should exist doesn’t, and then make it happen.

21. If I could have one day of feeling normal again I would: I’d do something spontaneous and enjoy how easy things can be. Go hiking and camping, go on some crazy road trip, do a marathon day of exploring a city, know i can sleep in a car or on a floor and not be too banged up, not need to worry about bringing all the meds and stuff I need, etc

23. Want to know a secret? One thing people say that gets under my skin is: There isn’t anything that really bothers me - for the most part everyone has been great. The unwanted pity thing is awkward, but doesn’t really get me mad. Honestly, my biggest problem has been getting people to say anything at all! I’ve gotten a lot of “sorry I disappeared, I didn’t know what to say” from people and I don’t want to make it worse!

24. But I love it when people: Notice when I can’t do something that the group is doing, and sit it out with me, or work to include me. Big family events and parties and stuff can be really sad when no one notices I can’t participate! Other than that, just stay in my life, & accept what I tell them as true. Also people who ask respectful questions:)

25. My favorite motto, scripture, quote that gets me through tough times is: even bad days have 24 hours

26. When someone is diagnosed I’d like to tell them: 1. it is possible to have a good life with chronic illness 2. bad days don’t last forever 3. Your illness is valid, you belong in the chronic illness community, and you aren’t faking it even when you worry you are (almost everyone I know with chronic illness feels this way, I blame society) 4. be sympathetic to yourself - its ok to grieve and be sad about this 5. i believe in you

27. Something that has surprised me about living with an illness is: How boring and mundane it is! even big dramatic events are full of so much waiting and mundanity. Filling out paperwork in the ER and waiting for hours, making 7 phone calls to try and track down important test results, the monotony of managing medications, appointments, insurance, etc … idk I used to think that having a scary illness would make life more exciting or something, but it doesn’t feel that way from the inside

28. The nicest thing someone did for me when I wasn’t feeling well was: Oh gosh my family has done SO much for me. My ex really went above and beyond, and I’m forever grateful to her for that. And a major shoutout to all my chronic illness friends who have answered all my medical questions and helped me understand and cope with scary new test results

29. I’m involved with Invisible Illness Week because: there are SO many misconceptions about illness and disability, including the perception that you can tell if someone is sick/disabled by the way they look or act!

30. The fact that you read this list makes me feel: happy yay thanks for listening:)

PS - all photos were taken in the last 6 months, so during a time where I was already quite limited and dealing with a variety of chronic illnesses & symptoms. Even though I’ve seen some improvements in the last year, I’m still far to sick to manage school or a full time job and I have whole bunch of health issues I need to balance on a daily basis

Oh my god Odesta wedding and it looks like it’s going to get good screen time!!!! I can’t even cope right now, I’m already getting way too over emotional 

Originally posted by kayemotionless

This wedding will be the moment in the cinema that separates those who have read the book and those who haven’t because they will all be happy like “yay wedding” and “why are those people crying?” But we will just be sobbing because WE KNOW!