Patho 3 lectures

But it makes, like, more... Yeah. Mine, like, the one... I think it's, like, 10 bucks... And it... And then all of a sudden, like, it gives you five seconds to turn it off... I think after I've been, I think. No, I'll go through. Speaking of I did not get enough sleep for this. Wait, Right, right. Yeah. I haven't gotten up early in a while. Not this early. And then tomorrow, we have to be out. Around the same time. Because it's at 8:00? Is it past the HR? For a farm? I think so. Where's my phone? I have a schedule. I have this app that I've used every single year. Of college. Yeah. Yeah? Yeah. We have the same schedule. We probably do. Yeah. This and then population health. Mm hmm. And then farm, and the adult gay reaction. Yeah. We have the same closet. Okay, good. I think it was, like, that last year, too. I just feel real funny other people... Like, wait, wait. Okay. Okay. Okay, why can't I just watch the paper see lunch this weekend? It's not hard. It's a... Yeah, I know, but... it does feel bad, because I didn't do it. It's okay, I understand. I took notes. At some point, we made it. Yeah. I feel like I watched a little bit of, like, the first five minutes before the thing you started. I think it'll be okay. And why? She said, We'll go over more of this egg class. in your class. Oh, okay, so it's just incredible. Am I on the right one? There's two, there's a part one and right two. Yes, I am. Yeah. Is the WiFi, like, not working? I don't think so. Oh, there goes. Why is it cool? That energy drink is starting to hit me. Oh, in my jacket. No, it's okay. We're size today. Thank you, Dad. What's this class called? Superscology. Connie and, um, Rose were out there, and they're, like... What country are you looking to? I was like, Papa? Like, are we supposed to be there? Yeah. They're like, we're not sure. Okay. Okay, which one did we click? Oh, okay, cool. cool. I hate that it does this. Oh, how do you get yours to not mess up whenever you transfer it? Uh, I open it in keynote. Instead of PowerPoint, I open it in keynote, and then I just export it as a PDF. Mine always, like, look weird. Yeah, it'll... I don't care. Try to do it right now. Yeah, or no. I don't open it straight. That's a good note. I do keynote, and then there, or... So do it after. Like, Microsoft PowerPoint, and then... Okay. Wait, what's the problem? Why is it not working? Oh, it's like... My iPad now working. I don't need that. Thank you so much. Is keynote something you have to download? I thought it was just on your X. I should be on the guess. once girl like I'm working. When you're When is your birthday? July Are you fish? 21st, you said, right? Mm hmm. Wait, why is it not working? Are you, like, completely locked out? Yeah, well, the WiFi's, like, not working. Okay.'s not my bathroom so don't worry. I feel like I need to fix my face sometimes. Oh, no. I'm not eardropping to you. Not even my hotspot. Okay, let's shut this thing down. Oh, wait, you're about there? Yeah, I felt the shoes. Okay, what is it? I mean, that's what happens when I hear today. I think I'm gonna sit here. Okay. You're gonna what? We fear this would only happen to me on the first date. Mine's still loading. Did you connect it, like, like, through your password? It's okay. It'll be. It'll work. I read that, I was like, it was a... I mean, like, it's always to drive less... Thank you, the Lord Jesus. You're working. Did it work? Yes. Simon. I'm like, okay. Oh, yeah. Okay, I know, yeah. Um, yes. I know, my ass, for sure, like, as stressful situation, he's, like, accelerated. Do you get it, or do you want me to? Then you do. But, like, when you recommend... Huh. You don't remember me? Mm mm. Hold on, give me one second. How No. location. go. I wonder, like, where it happened. That's so stupid. But I'm hungry. I feel that. I haven't eaten today. That's why I'm waiting until after high school. Yeah, same. I was working down week one week. Huh? Did work after this? Um, I don't work till 4:00, 'cause we're supposed to have our class, but... Oh, you don't have class now, so... Oh, yeah. My stomach is... Like, as soon as I woke up, I was, like, Mackenzie. No, I think I've done getting ready, I'll see. Yeah. Yeah. Yeah. No, we really woke up this morning. And I heard her, she, like, got up and sat on the edge of the bed. She was like, let's skip. Oh yeah, I did. I was like, I don't wanna go. But, like, I'll take note of this. It's hard. Nah, she was coming with me. Oh, like the... No, that's... No. We're taking Pat, though, pharmacology.. And then we have population health. And then we have adult character. Oh, look. Okay, hang on. What's that? Adult geriatric. But don't think geriatric. Yeah, just go... I need to do my calendar, dude. Hmm? Yeah, of course. No, God, I haven't looked at anything. And then we have that own space where he switches online. Yeah. You have the HRC team, too. It locked. But that's next. Once this one's done in September. cute. She's super nice. Girl, you're at bed on 16%. Yeah, I forgot to charge it. I have one. Do you need it? Yeah. My stuff is always dying. My phone is a little low, too. Would you like that? Is this charger, right? Yeah. There you go, girl. Thank you. Get away. I think I've ever seen that, but I was like, I don't know what this is. I mean, I still don't know who she is, but... Actually... It is not working. It doesn't fit. It's fine. It can die. Okay. What the heck? But thank you. I appreciate it. I'll take one. Is this the only people that are here? Yes. Oh, really? Ottoman took the afternoon class, I was thinking. Why, get so quiet. Awkward. Well, good morning. Are you guys excited to be starting your J1? Clinical? I mean, you had some clinical last semester, but I love it more. Uh, clit a whole different time. So I made myself a notebook, 'cause they were talking about things. I was trying to think of something that I could think of, so I got a little cactus here. So, um, this is a two hour class, which is new for me. In the past, Patho was a three hour class. So we're starting at 9, so I know I'll be through at 10:50, but I gotta make sure if I keep going or something, y'all say, oh, class is done here. We need to stop. Before we get into talking a little bit about pain, there's some other things we want to talk about. We wanna go over the syllabus. You want to do a little bit of a court overview, talk about Elsevir and Sherpan. And I think that's where I want to start real quickly right now. You guys did that last semester, right? Where you had Sherpath, and you had readings, and some lessons and things there. Okay, so... the way that we access that this semester, there is a module. And it's gonna say, start here. And so if you, if you go there, there's a lot of information, but I, I, I knew that you'd had this last time, but I sort of summarized the different things that you would see. And when I get in there, I'll show you. There's a lot there. The Simmons and I tried to set it up so that you could only, at least for now, see one module at a time, so it doesn't look like it's just overwhelming. I know sometimes you guys would rather see maybe more than that, but we'll see how that goes. But let me go back here for just a second. Um, I heard from one student over the weekend, and I don't know if anybody else had any difficulties, but the way you access Sherpath is to go right here and just start here so you can kind of get the layout. But you go right here, and it's going to, let's see if this all works. I may have to. Okay, that's okay. Takes you to the court's plan. It's kind of loading some things. So how many of you did this successfully? How many have you went there? Oh, shoot. I guess I should say a different way. Did anybody have a problem? Okay, so, I know some people said they were told I needed an access code. Yes. So, you really don't, and we don't know why you got that message, so, um, I checked with a few people, and they said, Well, have them clear the cash, clear the cookies, that kind of thing. Um, I guess try that. Maybe I'll break here at the next hour. Try that and see if it helps, and if not, we need to figure out. Do you remember what you did last semester? Because you really don't need a code, but we don't know why you're having trouble. Yes. I remember last semester, they had to have, like, the people come in. Oh, they had all helped us, like, the company helped us with it. Interesting. Okay. Well, we tried to publish this last week because this is how you get access to your readings. And so when you, yes, I can access the access toad. Whenever we go to put it in there, it doesn't load fully into the library and it doesn't keep your book in there. Okay. But that's interesting. Well, let me show you what it should look like, and again, I know you saw this, but just to kind of, as far as discourse, we've kind of got some little subheadings in here. Oh, in fact, I can get... Okay, good. It opened everything. So there's, like, all about a structure and function of the nervous system. So we always start with a little bit of review of A and P, so when you click that all down era, then there's some reading specific to that. So I'm gonna tell you that on, as far as readings, you know, there's a lot of readings. Some of the structure and function of the nervous system is reviewed. So I'm going to leave that to you. There's also a pre-class lecture that kind of hits on the high points of what you need for the nervous system as a whole. rather than reading everything there ever was about the brain. So just kind of know that this is for you as you need it. And I realized I didn't even really introduce myself. come back to that in just a minute. Okay, so what you have, and probably you had some of the same stuff last semester, is you have a reading, you have a less, okay, there's lots of lessons. The lessons are like, I don't know, 5 or 10 minutes long, and again, some of these were probably maybe deeper than I think you needed to go. So I just kind of wanted to let you know that, the lessons a lot of times, I think, may be covered in our PowerPoint, or sometimes they go a little deeper. And then we'll talk about shadow health. Shadow Health is the one thing here that is an absolute assignment that you must do. So I'll talk about shadow health in just a little bit. Y'all did not do any shadow house last semester? No. Okay. Shadow Health is a, it's different in different courses. In this course, it's animations of the body. So you'll get to the nervous system and it'll open up and show you the brain and the different parts of the brain, in the heart, you know, it's going to show you the beating heart. And as you go through each screen, you will, um, You know, sometimes you have to push a button to interact with it, or you can't go forward. Sometimes you have to answer a quiz question, and you can't go forward until you get it right. It's not graded. It's just, you know, kind of checking your progress as you go. But I'll get to the assignments in just a minute. You can't just push play, walk off and leave. So you do kind of have to interact with it. So there are six of these assignments. So this is something that you have to do. Here's another lesson. Okay? Well, I'm gonna skip forward just a minute to module two. And okay, the thing, the thing that I recommend that you do, if there's ever an osmosis video, those, I think, are especially helpful. I think, again, the lessons are for you to decide if they're helpful. Sometimes there may be some review questions. Um, but the osmosis videos are awesome. So I'm gonna just really put a plug in for those. Okay? All right. So that's getting into week two. Alright. So when we take a break here in a little bit, I'm gonna run upstairs and try to figure out what may be going on. Nobody, nobody got in. Is that right? Nobody. You said you got in, but it's not loading the book. Yeah, I put it in and now I don't ever go to do it. It's already been redeemed and I haven't been able to access it. Okay. All right. Well, we will fix that. This shadow valve assignment, I think they're always gonna be due on Sunday, but if there's any delay in getting you set up, we could certainly, you know, give grace on that, because that's not on you. All right, well, this was the thing I wanted to find out, and then, let's see. Oh, so, I think when you, yeah, there, when you click this, it's gonna take you to the book. When you click some of these other things, it's just gonna take you right there. What are you talking just briefly about adaptive quizzes? Mrs. Simmons and I may use those a little differently, because our book has things combined. So our first, we're talking about pain. But pain is in a chapter of the Huther book that also, yes, I'm a little warm here too. Is it okay if I open the door, if it gets noisy, I'll close it. But I'm a little... a little warm all day. pork. We need to get back there, we can. Um. We're look. Oh. So there are quizzes, which I'm happy for. But because our book includes pain, and temperature, and sleep, and sensory, it's complicated to set up a quiz where you would only get pain questions. And I tried that, and I didn't find as many that I liked, and if we set up a custom quiz, I can't see the question. So you would just get a random set of 20 questions, and I don't know what they are. So, for now, I may create some quizzes and let them just be optional, and you guys tell me how they work. I have some other options for practice quizzes. So we'll get to that a little later. But we're still kind of figuring out we are. This is a new product for us. Okay, well, we'll come back to that. So, hi. I'm Tammy Andrews. Um, I've been at UMHB for 10 years now, uh, teaching Patho the whole time. I'm also the clinical liaison for J1. And next semester for J2. So what that means is that I will visit the clinical sites every time that you're in clinical and check in with you and your faculty and see if there's any, you know, anything going on. So you will see me quite a bit. Um, And I'll be at your clint orientation on Thursday and dose it to Cal. So I'll be around quite a bit. Before I came here, I taught health assessment at UT Arlington for 12 years. So I've been academia for a long time, and I just love teaching because I learn. You know, it makes me learn. I love learning. Call you a geek, whatever. I love learning. I love words. A lot of times you'll hear me say something about, you know, breaking down words. If you can, if you can figure out what a word means. Sometimes I'll test, somebody will raise their hand and say, I don't know what the word means. So I think it's good to try to figure out words before we, you know, get to a test. So that's me. I'll tell more as we go on the pain lecture. I've got a picture of my dog. I'll tell about her. I love to death. I love to. This sounds weird. I don't love to rap, except that I like the beat, and I've got a rap song that I do when I teach eyes and ears at the end of the semester. I used to use that at UTA. So sometimes if you see me, if somebody's playing music, I may just sort of, you know, get a travels out of here. So I want to learn more about you guys. In just a minute. I'm going to call your names and try to learn the names. As I've gotten older, I find that that's harder. And so sometimes if you see me looking like a deer in the headlights, I'm like, what is her name? my gosh. I remember her name. I have an interesting assignment. show you that we're gonna do this semester to help with that. Okay, let me show you a couple of other things. All right. Man, it is really a little toasty in here. I'm hoping that's gonna get better. All right, so this is our course calendar. I don't know if you know this. I don't know if I said it in an announcement. I probably didn't. That this course lines up with your adult Jerry course. So on Monday, you're gonna be talking about the pathophysiology of whatever disease. Pain, coronary art, well, let's see. Yeah, coronary artery disease. peripheral vascular disease. On Tuesday, it's the same content, but you're applying it as to how do I take care of the patient who has that? So, you know, we believe really strongly that the 2 courses are very married, and it really helps when you're taking care of a patient, to not just know they have pain, but to know what is happening in the body that's causing it. or what is causing their vaster disease. And you're also gonna have pharmacology this semester. I may make some brief references so I can tie something back to the path, though. This week we're going to talk a little bit about pain, and then briefly, I'm going to mention. This med may be given because it addresses this part of the patho. So this is what's going on in the body and this is how it works to correct that. Something else I'm going to mention, so you'll see that we've got three weeks and then an exam. So I will be posting the blueprint this week. I usually have it almost have it posted already, but this semester, we've changed some of our concepts and exemplars a little bit. So I need to update that. So our test will be on Monday, on Monday the 31st. And so you can see what we're studying in the meantime. Next, next week, I'll just put a plug in there. This is probably one of the most thorough, detailed, comprehensive lectures of the semester. Inflammation, I don't know how much you know about inflammation. It's kind of like the basis in some way, of almost every disease we have. You know, it's kind of obvious thinking about somebody who has an infection and they have some redness. or they've got a rash or they've got an injury. Somebody has asthma. So actually, things like diabetes, heart disease, there's all a basis in inflammation. So this is one I would really, if you don't even, if you're not a reader, I would suggest you do some reading, and you're gonna see there's 3 different pre-class lectures, and then the class lecture. So you guys at least were able to get into canvas, right? And you saw that there was a pre-class lecture, and it's recorded on Penopto Video, so you can, you know, take notes and you can listen. And for at least for a module A, I've also recorded the class lecture. I don't know that I will do that every time, but as we're looking at this kind of transition into a two hour class, I think it would be helpful. So I don't know how many of you would go back and listen. I listen to myself as I'm driving into work just to kind of refresh myself so I listen today too. So this is your calendar, just a couple of things to point out. September 7th is Labor Day, but we don't take that as a holiday because we have the fall break. in October. So you'll have 2 days off in October, and this material will be all online. Okay? Of course, I will always be available to, you know, answer questions about anything that we weren't here to have, you know, to be in person. So this is the calendar, and we have four exam, three exams and a final. Final exam will be before Thanksgiving. Make a note of this. All of our other exams are on Monday. during class time. So your first example will be on a Monday at 9 o'clock. This test, because Thanksgiving week, you know, it was very short, and we need to have all the grades in, and everybody's trying to test. So final exam will be on a Friday. So put that on your calendar so you don't schedule yourself to work, okay? Friday, November 20th. Okay. So that's the calendar. I. I know what that is. I think I would have something wrong. It's not mine. That's weird. There are two things, two handouts. One of them, I meant to open. Yeah, that's right. This is kind of how I would suggest that you approach and study pathos. So for every disease that we're going to study, there's risk factors. Who is at risk to have pain? At risk for heart disease, who's at risk for pneumonia? The etiology, which is the cause, the pathophysiology are sometimes the pathogenesis, which is the step-by-step process. Okay, this happens, this, this, and at the end, you get the clinical manifestation. So there's this whole process that leads to this. And these are the diagnostic tests. We probably won't do much of treatment anymore, but I may say a word just every now and then. So this is in the Kansas module. You'll find that. And I think. that's all we need to say about that. So let me go back to the canvas. And I'm trying to remember how to go back to campus. Okay. Um, let's do this. Let's see. I think I want to call names, because I want to know who you are. Then we'll do the syllabus. I like to start off. with a scripture. Today, as I said, I had some technical difficulties, so I'm gonna post this, usually post this announcement anyway. see if I can find it. Well, the scripture is Psalm 139 talking about where fearfully and wonderfully made, which I just think is so perfect when we study hypophysiology. As we go through the semester, what is so just amazing is how we're created by our Savior and how we have these compensatory mechanisms. You know, there's things in place, so hopefully this doesn't happen. But sometimes it will, but there's, there's these neganisms in place that try to protect us. We'll even talk about one of those today with pain. So I'm gonna, I'll post that and, um, and, you know, try to put that in, um, kind of include that every time, every chance we get. All right, so I'm gonna call names. And, please, forgive me, if I don't pronounce it right. Now, please tell me how to pronounce it or what you want to go by. Okay, I've got... I've got the right section here. Ayana, Baker? The Ion or Aon? Ion. Okay. Good. All right, Audrey, Enfield? Okay. Kylie Blomquitz? Natalia Calderon? Natalia? Paige Darlington. Carolyn Inke? So far am I hitting it right? Okay. Today, the carry? Right, right there. Okay. You're my advisor, please. Uh, I'll pay. Is it Nur? Hernandez? Hi. Yeah. Ner, okay. Francis Gutierrez? Yeah. Is that right? Yes. Sayed, Hyder? Yes. Is that correct?? Julia Anne Landis? Julia or Julia Ann? It's just Julie. Julia, okay? Amanda. McKenzie, Lara? Right here. Kaylyn Larrabee? Another advisor of mine. Tate O'Neill? Um, is it Ella or LMA Parsons? LMA. LMA. Anastasia perfumes or anastasia? Anastasia. Anastasia, okay? Alyssa Pittman? Okay. Ashley Bradford? Ashley. on the other section here. Kaitlyn Roblato. Crystal Rodriguez here? Uh, Riley Roe? Is that right? Zachary Rosenka? Zach Or Rosie. Zach Rosie, okay? Aurora, short? Natalie Smith? Here. Annabella Strong? Here. Alyssa Torres. Rihanna Villa? Here. Mia Vegas? Here. Oh, my God. Ellie Warren? Hey, Waterman? Taylor Westmoreland? Chloe Williams? Mallory Woolman? Hayden Yarbrough. Anybody whose name I didn't call? Well, let me show you one of the assignments I have. Um... It's a new assignment. I've never done this before. Oh, goodness. That I was looking for, I was thinking, like, how can I learn everybody's name? I don't know how. I'm gonna learn anything. Remember everybody's name. Other than making you wear name tags or face, you know, the little tents. I don't know people don't like that. So I asked AI. We're going to talk about that AI, and then of course, there's some things you can do, and things not. But I asked AI, and it gave me a great idea. So, your first assignment is... this. Oh, I have opened it yet. It's called video introduction. What you're gonna do is you're going to create a tent, a 15 second video, upload it, just telling me your name, and what you're excited to study about, patho, or what you're afraid to study about, patho, and maybe one other interesting thing. And I'm assuming, again, I'm not a type person, but a friend, one of my other colleagues had her students do a video, um, reflection or something. And so I think it's gonna load it as a either an MP4 or an MOV file. So if anybody has any, you know, worries about how to do that, let me know. But I'm gonna take some time and try to look at those and see if that's gonna help me remember names. I could pull them out together and go, 0 yeah. So I think that's kind of fun, right? I mean, your 1st assignment may be something a little different. Okay. So let's jump into the syllabus, and this is where I feel like I'm putting on my police and hat, you know, like all the things we talked about today. So, let me ask you first, are you guys able to see the simple syllabus? Mm hmm. This is one of those things that doesn't have a student view, so I go to student view and think, oh, it's not there, but I've learned that for some reason, it's not tied to student view. So we're not gonna go over every less thing. Actually, I'm gonna need my marker here. So, this is my office, is upstairs on the third floor, right by kind of the little intersection on the hall where Miss Sharp's office is. Office hours, I have to kind of put something, but I'm willing to meet other times. So I put on Tuesday, which I know people are in class, and then I'm doing a lot of clinical on Wednesday and Thursday, but I'm free in the afternoons, or if you just say I need to meet a different day, we'll work something out, okay? All right. Of course... The objective, the learning outcomes. Uh, the textbooks show the Hugher mechanics, which is tied to the El Severe and Giddens Concept book. All right, come on. Nope, not that way. All right, assignments engraving. So you can read that... All right, so we will have three module exams that are each worth 20% for a total of 60%. We will have one final exam, which is worth 30%. And then quizzes and daily work. For that, mostly what we're gonna do, and I'll show you what it looks like, is their worksheets, they're kind of like tying patho to clinical. So I'll show you that before we go here in a bit. So, um, There's a, there's like a table, and in this table, you'll put, uh, you get to pick. There's usually like, for this week, it's either neuropathic paint or nose deceptive pain. Sometimes it's UTI or HIV. Yeah, it's like what, you get a choice. So in there, you're gonna tell me, in your own words, what is, what are the steps? What's kind of the what is the summary of the path, though? Then there's the next box, is you'll say, how would I explain that to a patient in terms they would understand? And then you're going to talk about the clinical manifestations and, um, diagnostic tests, and there's several different things. Okay? Then, the Shadow Health. So you have you probably will have one of these every week that we don't have a test. And then Shadow Hell. So that's what makes up our assignment, and we don't do any extra credit. Okay. Um, no rounding, knowing about that. Now, this is something new. this semester looking at artificial intelligence. I'm just curious really quickly, how do you guys use AI? I'm really curious to know. What are some things? Yes. Uh, I use this last semester to help generate quizzes in, uh, test to help me study for the upcoming exam. Okay. All right. So was it helpful? Depending on the platform, yes, ma'am. See, I had students tell me that they would have it write test questions for them, but they weren't very good. So what I suggested is that you need to tell AI, you know, please prepare in a collect style questions for a student and a nursing student in pathophysiology. Um, that are, and you may need to say, you know, that you want them to be higher level, so that they're gonna be kind of the same rigor as our exam questions. Okay? Yes. I think about it a lot better luck using AI to, like, summarize concepts or, like, break things down into different, like, perspective, especially with, like, anatomy and physiology, something that, like, has a lot of papers in the internet that's reliable than, like, an opinion of our nursing school. Okay. Because we have our own AIs and our house here. Yes, and all these that to my question. That's amazing.iable. But like chat GBT or the other ones, they're really helpful and like rephrase those to make it make sense. That's what I use AI for. So as I was preparing this lecture, we talk a little bit about the gate control theory of pain, and I understand it, but I'm like, how can I make this simpler, you know, for students? And so I'm glad that you said that, because if I'm studying something, and even before AI, we still had the internet, Google, and I'm like, I really understand something. I ask, and I get it to break it down for me, you know, because there's things sometimes that I haven't looked at it in a while. So I think that's a great use of AI. Anybody else have different use? Yes. I have an app, but, like, I can put my notes in, and it can, like, create a podcast. I've heard of it. Notebook, elements, or something. Yeah. I think that's pretty clever. Yeah, that's good. nice. It helped me a lot last semester. I think it kind of changed like my trajectory. Okay. Anybody else? There's another app called Study Fetch. It is a paid thing. I paid for it last semester. I think it was like so helpful. I think it's like $20 a month where you can buy the year. Okay. But it does podcasts. It helps. It will teach it to you. Like you can do a live interactive feature where you upload your notes and you can be like, it'll ask you questions and you have to explain it back. And so it's only using your notes and your, like, um, like PowerPoints, thank you to use it. It's not actually pulling in other AI things. So it's only what the material is. And you can turn in like parts of your textbook too, and it'll only use that. it's a more reliable kind of AI. So then with the test questions, instead of generating it through like ChatGPT or something, it's very accurate to how y'all would ask it on a test. And I found that out. So, ChatGPT, what other platform? Anybody do copilot? That is my favorite one. Co pilots like Microsoft, and you can, I have co pilot on my phone, and it's so bizarre. My brother showed me all this one day. I'm not gonna get into it now, but, you know, copilot, if I ask you a question, it's gonna have a conversation with me, and if I don't answer back, back, like, are you still there? Can I help you with anything else? How's your day going? I was kind of like, this is a little creepy, but okay, thanks, appreciate it. Co-pilot is good. and then Google has Gemini. So there's an, I know there's more than that. But... All right, well, we won't spend too much time, but so here's the takeaway here, is that they kind of, you know, it's, I remember, I think it was, like, four years ago, we had this big backtope, you know, beginning of the semester faculty meeting, where most of us didn't know too much about AI, and chat GPT. And we sat in a meeting where they were telling us how people could have chat GPT create all kinds of things for them. And as a faculty, we were like, Oh, no, you know, like this could be scary. So what they've come up with is this red, light, green, light, yellow light, kind of structure for how AI could be used in the course. So, you know, red light means, eh, not at all. Green light means whatever, and then yellow lights kind of in the middle. In this course, there's not really, there's the weekly worksheets, and that's really, I think, about it. So, I'm all about helping, you know, having it help you summarize, but, and I've got this listed on the actual assignment. In no way, would it be okay to upload the assignment and say, Chat GPT, do this assignment for me, and then upload it? So just so that we're clear, that's because that's taken away your thinking. You know, you don't want to be in a patient's room, and because chat GPT has done the work for you, you don't know what to do. So that, so I guess I would say yellow light, just with all the other study kinds of things, but as far as an assignment, and there's something that's, be sure that you know this. There are some cautions about uploading things, like from the library or things because of licenses. So you'd have to be really careful with things that you uploaded and asked it to do some work for. So make sure you read that. Okay. Of course family go again. Well. Yeah. I do that at least once. Once that's a semester year. Stop that. Okay. That's a little crazy. I have my integrity, of course, you know, this work is expected to be original work. So a lot of this has to do with the things that they were talking about this morning about being on time, so we will take attendance pretty much at 9 o'clock. You know, there are a few exceptions. We all know that sometimes you're coming in 35, and there's a wreck that shuts the freeway down. That's different. That doesn't happen every week. So if there's some way that you can communicate, send me a text, you know, pass the word onto somebody else safely, if you're not driving. But really do, we are looking for you guys to be here on time. Barring some, you know, unusual type of things. If you're ill, what I would say is, or, you know, if you can't make it to class, text me, but then also email me, and I'll give you my email. Maybe it was up there. I'll give you my phone number here in just a minute. But, um, it's hard for me to track texts. I don't want to have to go back and... what's going on here. door open it's hot here. It's easier for me to track an email, so I can go back and find that somebody has let me know they weren't gonna be here. So, I'm gonna go ahead and write my phone number here for texts. Okay, that's my text. I, um... pretty much, I'm up at five. I'm trying to stop answering things after, like, 9:00 at night, but you could still leave the text, and I would get it. All right, let's see what else is. There's some opportunities for interprofessional education. You guys will be participating in poverty salmon, it's good for, again, attendance. I think we talked about that. again. If you do come late, you know, be sure and come in quietly, like you mentioned today. And then I get attendance, very important. Which that's, you know, lots of AI policies now. If you have accommodations, I think I'm hearing from the folks, make sure that you take care of that. As soon as possible, just so we get another by that before, you know, assignments or exams. so we know that. If you wanted to record the class, that would be fine. You just always need to let me know, just as a courtesy that somebody's recording. I think the rest of this, you guys can leave, but I will create a syllabus quiz, which is a quiz that has one question, and the answer is yes. I have read and understand the syllables. So I haven't opened it yet, but make sure that you do read the syllabus before you check that little box. All right. Oh, there's something else. Questions so far, and I think we'll go ahead and get into our content, if we don't have a whole lot of time, yes. Um, for the attractions of you, there's the assignment of, and... I thought I opened it a minute ago, but it may not have... check that.. Oh, you Probably didn't open the whole module itself. Can you sit down? Is it open? Yes, sir, it is open. Okay. We just can't push the spam of course, till 11. Oh. All right. You can't participate in the course until you have it. No. I love it, man. That would be... Okay, I'll have to look at that, too. That's weird. Okay. There's always a weird thing that happened the first week, so we'll fix all of that. We're gonna take a break. So our usual plan, again, adjusting to a two hour place, will take a break here. Why don't we take it now, and then we'll start... usually we'll take it, like, at 10 to the hour. Let's go and take it down, take 10 minutes, and then we'll come back and jump into pain. I still, that sounds fine. Because you're hungry? I can't even see it, do you see it? Where are you going to bath? Yes. I can't even see this. I don't. I remember... It's because we're not allowed access to... Do you want a dog? And you're gonna do the assignment, I'll go. Yeah, that's good. Oh, my God. You left your party, at least for now. All of my day is also... You know, I'm not a relatively officer. Thank you. All right, I will be back. I'm so well, you don't have any... No, yeah. Yeah, I... Oh, my gosh. We all have to contact Elsevere. Oh, really? That's great. So, like, that makes the glass. I'm ready to go on. And we don't have another class. That's good. dried my hair. Mm hmm. And I really like the area. Yeah, I did, but, like, it's there. I need to. It's so much easier to manage to wash my hair. there. Are you ready for one? Honestly... This semester, I'm just, like... It doesn't. You don't need to know that. I'm like, it is what it is, but I don't need to be like that, but it's hard. Just, like, whatever. This is not working as possible. I was like that last... No, I was like that last semester, too. Ever. God, what is wrong with this thing? My what? Oh, yeah. I got a new car. Right. nearest? Yeah, it's good. I think it was just, like, sprained or sheet. Why is this a lot to move? This is why? I hate that. No, it's not my pain, it's this, like, anyway. Find the other people, I turn my Wi-Fi off. That's why I do have it off, but... Oh, my... She has to... It looks so nice. I to tell you that. I thought you were, like, one or two layers. Hold on. So, you have to let you have an invitation... I mean, it's terrible. A lot of you see, though. No, what is she? I know. I know. I know. I know, and they're always, like, always going through them. Like, I can't, like... And I'm like, oh, what? Yes, I know what to do. Yeah. The. About to flip? What? I'm just thinking ain't working. I'm gonna just figure it out. Later today. Is yours working? Mm mm. But I downloaded all the stuff, all the PowerPoints, before. and just uploaded them to my iPad. Well, I was just trying to do my calendar. Oh, I have Google Calendar. I mean, I'm not gonna be able to do it anyway. 'Cause I can't leave. I mean... Oh. Oh, my God. Do you remember the last message of my son was running so long? And you can do that now? Except he's hungry here. No, outside. I'm Phil? How about if you've lost your? Oh, look. Yeah, bro, I want you to invite... Oh, my God. She said... Oh, my... Oh, my... I forgot. I was, like... I was, like... I literally have my shape with me. If we want to have that... I'm tired. Bra. bye. What's going on? Oh, my God, my bag's stuck. Okay, don't leave it. Chocolate? I don't know. You know, sorry, we were talking about... Well, what? I thought, like, we got Cece and there were some real school. It goes with everybody. Oh, yeah? No, but I'm saying, I thought they had said that they were in the morning. I don't remember her. She was like, I'll see you in a drink. It's like, Okay. Unless this... another? I kind of like that she's not. I'm not trying to be weird. Like... I feel like this class is chill. I You know what I mean? Do You're well known. Because my stick is 30. She's like, It's gonna be my golden birthday. It's gonna be mine, too. excited. What's our... Is she gonna do anything? She wants to. I don't know what she wants to do. If she has some... You know, like, the day of? Thank you, though. I just know she said she wants a party. So I'm trying to, like... She's the baby. I was gonna have a dinner. And I'm inviting you guys, but it's in Dallas. Can you just smell it? Dinner for everything? I literally was already thinking about seeing a few, 'cause I didn't know if you were gonna go home for your birthday, or if I was gonna have, like, the friends here stood you, if you couldn't go home. Yeah, so... I don't know, I kind of want to talk to you all. It would be that Saturday of my birthday, so... But I'm talking about on your birthday. Oh, okay. I thought about getting every, like, the girls together and we could go celebrate you. Yeah. 24. So the 26th. What? Okay. I'm thinking about a dinner in Dallas, like, inviting you guys, but I had talked to Jonah, like, would you come, even though, like... You didn't really know her? Because you know drunk. If he doesn't know nobody, he's gonna touch me. He knows me. And her. He said he would go. And so I split you guys? The only thing is, is I do... I've never drove in, like, dash. Sorry? I've never drunk it, though. It's not bad, I probably. Like, whenever I went to that wedding... Like, my birthday? I just... Like, Dallas people... And then I had temple people, because that's what I would invite, because I don't know anyone. Yeah. So I was like, well, we could do something small in temple if y'all don't want to drive. Well that's... It was literally up to you guys. Like, it's... That's how, like, when we went to the wedding, Jaden drove back. Because I can't. Yeah, I don't care. Like, I literally won't be hurt. I split y'all 'cause I didn't want to put y'all in the group chat. Are you smiling? If, like, I didn't come. Y'all just let me know. Where are we going, hibachia? Oh, I don't know enough about that much. I don't know that much... I know. Hopefully, none of us get a clinical... What? 'Cause Saturday? What? Shut up. You're lying. I only thought I was gonna say Thursday. You said Thursday, Saturday. What? So it could be one of those... The clinical? Wednesday, Thursday? No, no, no, no, no, no, no, no, no, no, no, no. That ruins everything for me. Yeah. No, you're lying. I'm about to start fighting Bill. I really thought it was... But two, you could be assigned, not a Saturday, because one of the Saturdays, you have to go with the Thursday. So, well, that week, that's Saturday. But it depends what where we get assigned. What day is it on? It's on the 26th. She wants to do. No, you want to do it on your birthday on the 26th? Oh, so the Saturday after your birthday? Can you take care of that? Yeah, well, I might have a clinical my birthday, so. I don't know. See, it also depends if I could take off that day, too. But if I tell him? You just ruined her day. I'm sorry. Thanks, Francis. No, I'm kidding. I had to go home with her, thanks. I really thought it was only Wednesday, Thursday, but I did see something about a Saturday, and I was like, Why would this Saturday group have to go to a clinical on Thursday? I was like, huh? I should have put it on YouTube, like, the YouTube excelling version. I'm gonna cut up my eyes. Fuck the guy. I want to watch this Spider Man, like, one in, like, XB. I watched it... I watched it... I want to, like, have, like, the sermon. It was, like... No kidding. It was not helpful. Aw. It's a lot of earrings. That's what I'm trying to, like, put him. When's your birthday? On the 9th of September, September 9th? I rushed around to go, too. So, should we get it, you next week? I should try to do our electric on TikTok. All right, everybody's back. I can't tell. started Thanks. All right, so I have more questions. here. Uh, I did not realize that it that, somehow, the cores were not scattered open until 11, so my question is, you said you could see the syllabus? Yeah, we can. But you couldn't have seen the announcement, but the assignments? No. That is so weird. So, I wondered, but that sounds, I don't know that that's the case. If that's what kept you get it from getting in the shirt pass, I don't know, but it sounds like... It's not sure about isn't working for my other courses. Okay. okay. So it's not just your... Okay, open it. Yeah, it was it, that was it. I did. don't listen to me. So here's what the other thing is weird. See, Ms. Simmons and I, our officers are right next to each other, so we talk a lot. So we were both looking, we can go to people, and we can see who has exited the course. So it looked like, you know, about half the people had accessed the course, so we thought all was good. So let me just say, in the future, please let us know, like, um, are we supposed to be able to see the course? We can't see anything. Please let us know that we want to fix things here. Were you guys all able to get to the class recording or that kind of thing? Do it. Okay. The pinato and the power... You can't interact with it. Like, we can't turn anything in. Okay, so you can see the monitor that had... Okay, then. Well, that way, like, you can take... You could just check. They spent, like, a bunch of... It's a... Yeah, Oh, good. Oh, bless. Yeah, sure. Yay. Are you in? I was really stressed out about it. In what? Surepad? I can't... I can't be good, too. It does work. That's cool. What? How is this working? Sure pad? Yeah, it's working. Well, maybe, maybe, the number... I thought it was all... It was tagged over, sister. Okay, you know, we live in a wonderful age. I mean, I grew up in the '70s. We didn't have fun with him anything. And sometimes things with the silver magnet, but I'm sorry for, you know, text stuff. Thank you. All right, so we are gonna get to... pain. Oh, yes. So, um, told me kind this. Kind of the usual, you know, like, today, we have to start with the syllabus and overview and all of that. But typically, each week, you'll always have a pre class recorded lecture. Review of A and P, because I find that people kind of need that. You haven't thought about some of those things in a while. The concept... and... this is gonna be difficult. If somebody's down here, I would have to put a red light there, like, it's quiet. Um... So we will always have a pre class lecture. We'll come in, and the class is two hours. Everybody's glad to see each other again. So, instead of having two hours of just lecture, we're gonna have some activities of some kind, and it will vary from week to week. So it's very likely that I won't get too all of the content in class, so I will probably end up recording, you know, the lectures for most weeks. But, um, I would say, really, it will help if you come having, um, watched the preclass lecture recording and be, you know, somewhat familiar, and if you can at least, uh, have done some of the Sherpath reading, then it will help, too. All right, so let's go, I don't know how much of this will get done, but I like to start off with a picture of my dog. Oh, yes. This is Avery, Avery Andrews. I'm gonna say, um, she's 11 now. She's a spaniel dachshund mix. Oh, cute. She is... She's a mess. I'll just play that. Um, she, until, I don't know, maybe five years ago, she wasn't afraid of anything now. She was terrified of fireworks and storms, and sometimes just rang. She'll come, and she's just, like, acting really weird. I'm like, What? And then I go, Oh, there's a little bit of rain outside. So strange. And she just trembles, like, all over. And I have a little thing kind of like that, a thunder shirt. didn't have anti exciting, didn't help. So I just kind of have to hold her, put her in the crank sometimes, just to, you know, whatever, but... Anyway, she and Sal. She's... She's got the myth of it, I'll just tell you what, my husband, sometimes she'll wake me up in the middle of the night to go potty, and then what does she do? She doesn't hunt. I get the game. Everything is a game. Oh, Amy, it's 2:00 in the morning, it's not a good time for games. All right, so, we're gonna talk about pain, um, in almost every class, as it applies, I'm always gonna ask you, and I'll ask you in just a minute, if you want to share something, uh, about, you know, yourself, uh, pain, and, you know, think about this for a minute, um, you know, who has had something that some painful experience. It is totally up to you if you want to say, you know, yes or no, or just refrain. Don't ever want to put anybody on the defensive there. So before we do that, you know, you can see all these different definitions of pain. We're gonna talk about pain and nose infection, which is the process of the patho. It's usually protective. I think we're going to have the slide where the person touches the hot stub, and then they withdraw real quickly so that they don't just leave it there and get burned. Pain, a lot of times, will tell somebody, they need to go seek treatment. And they, they, you know, sometimes people have found, like, a tumor that was there a long time, and they didn't notice it until the pain. It helps, you know, helps you be aware of something. Last statement is very important, although pain is expressed verbally, not commuting it, communicating about pain does not mean the person doesn't have pain. Something that was very eye opening to me, um, 10, 20 years ago, um, you've heard, have you heard of Margot McCaffrey? She's the one that says pain is whatever the person says it is. So she's like the guru pain. Well, she and her colleagues came to our hospital, and I had never thought about people in the ICU in a coma. Maybe they've had a car accident, maybe they've had some trauma, but they're in a coma, she was like, for those people, depending on what their reason for being there is, we're going to assume that they have paid. We're not going to assume that they don't, just because they can't tell us, they're paralyzed, and they're gonna coma. Why would we assume that somebody who was in a horrific car crash doesn't have pain? So that was pretty eye opening to me. And so one other thing I will tell you, that I have sometimes observed in my 22 years of teaching in the clinical setting, sometimes... Steph have maybe become a little jaded about some patients who are drug seeking. I don't say that they're not. But sometimes people get a little over that, and they assume everybody is fake. So I've had a few people tell me, Oh, your student has the patient in 12? Okay, well, that patient's gonna try to fool them into thinking they have pain so they can get more pain. Be very cautious about, you know, if somebody says something like that, just say, okay, you know, or, you know, I'm going to do my assessment or whatever, because it just horrifies me to think that somebody might not get taken care of because people made an assumption about them. Even somebody who has had an addictive behavior could still be in pain, and we still treat them. So that's kind of my bias. I hope you never see that. And honestly, I've never seen that at Bannerscotton White. This was in another city. So just be alert that, yes, people could be drug seeking, but the evidence tells us that the most accurate information about pain is the patient's self report. Even if they don't look like they're in pain to me. Okay. So who would like to share some paper thing that happened? You know, kidney stones, ooh, um, fracture or whatever. I had a kidney stone. I I hear that part one of the most painful things you can have. Yeah, it was rather sudden so there was no warning sign and then all of a sudden. My brothers had many and my dad said many. somebody over here. Anybody here had a baby yet? Had a baby, I know you didn't know that. Yes. You're going back to certain patients with certain pasts, and I, I mean, I do have her personal experience that I know a couple people, one of them, me and my brother, who was an addict for so long, and they, these people that I know, they have, as soon as they go to the hospital, they got, they come straight up, say, hey, I have a history of... uh, OPUs. And when they do the when the nurses or doctors do their assessment, they have to take that consideration. Right. But from my experience, they never looked at them and was like, hey, That's good. No, they're not just thinking they're clearly in recovery. They've been recovering for years, but we do have to take that level of tolerance, however old or new, into consideration when administering payments. And you're right, there's a position paper, the American Society for Pain Management Nursing has some guidelines, you know, for people that are in recovery and they don't want to take an opioid, but how do we manage their pain? So there's ways to address it with some kind of multidisciplinary interdisciplinary pain. So I'm glad that they were looking at that very, you know. Yes. Just from personal experience, I've been diagnosed with chronic intractable migraines for about six, 7 years now. I mean, it's probably been about 7 actually. So that's not fun, but, you know, we finally are on the right meds, and it took us about 5 years of people telling me, oh, it's just stress, and oh, it's just this, and oh, it's just that, oh, you're a girl, like all these things. And I'm like, no, like, name is a 1st one. I can't get up out of bed. I have to have things black. Like, it's horrible. So the question I also usually ask people is when you were in pain, kidney stone, headache. Did you look like you were in pain? How did you look? And if somebody looked at you, would they know you were in pain? From the traditional standpoint? Probably. Okay. Yeah. So, um, when I, when Margaret McCaffrey and Chris Caro came, they said that they, they actually taught their family members how they should look so that the staff would know they were in pain. Like they talked them how to grimace, which is just, you know, kind of sad, but so as nurses, just keep that in mind. It's an open mind, you know, don't make a judgment until you have done your own assessment. Uh, concept map, um, you can see that in a Giddens book. And one thing I point out is, some of these are, like, a one way relationship, like pain and how it affects mood and effect or sleep. But, like, things like culture is a two way. So culture affects, you know, how you experience pain and pain is somewhat dependent on, you know, your background and I always say too, if people have had a history of being in pain and it got relieved, that's one experience, or if they had pain that was difficult, or did not, you know, people did not listen to them, that also can impact them. All right. So, the term actual or potential tissue damage, potential tissue damage, is what I mentioned, the hot stove, or something that it warns you so that you don't, like, you could have had pain, but that protective mechanism kept you from having actual tissue damage. Or you could have actual tissue damage, lots of different things. One of the common reasons that people seek treatment. All right, so in every week, we're gonna talk about risk factors. What puts someone at risk to have pain or to have whatever we're talking about? And there's always the age spectrum. There's, um... So, you know, I think about neonates, and they're having lots of procedures. Um, older adults just have maybe some chronic medical conditions. Sometimes older adults, if you ask them about their pain, and they tell you, and then you say, well, I'd like to get you some pain medicine, and I'm like, oh, no, and this may not just be older people, but they said, oh, no, I'm going to wait. It's not that bad now, and they use the term. I'm just gonna save it up. for later. And actually, my lesson would be, that's really not good, because if you wait until later, the pain intensity may be a lot greater. It's better to go ahead and take medicine now. And we're gonna see the physiologic consequences of unrelieved pain, but we need people to get up and walk and move and take deep breaths. Better to do that if they've had some pain medicine. Oh, um, let's see. So a couple of things down here. Fear of addiction. So some patients have that fear of addiction. Do you know of another word that would be a better term of what people could experience, but they would call it addiction? Yes. Cependency? Um, not the word I was looking for, but I could see what you were talking about there. There's another term, and we have it on a slide here called Tolerance. So, tolerance is kind of has a couple of definitions. It's how much pain you can tolerate before you need to do something. But also, it's something that can change. If a patient has, let's say, a patient has cancer and they start out and they're like me, the term is opioid, naive. I don't routinely take morphine or hydrocodone. So I'm opioid naive, but if I get put on a regimen of that, there may be a point at which the dose I'm on, I become tolerant too, and I need a higher dose to achieve the same results. So we have to educate people that there's a difference, you know, addiction is physiologic, but it's also psychologic, and that I am seeking, there's some seeking behaviors, tolerance is just strictly my body is adjusting, and needs a higher dose. But when people worry about addiction, that's not, you know, they're kind of misinformed. The other thing, sometimes healthcare providers have an exaggerated fear of, I don't want to give this person this med and make them stop breathing. And, I mean, that, that's a, you know, understandable awareness. But what we need to know is that anytime we give payments, we're going to do an assessment. We gonna assess, what are we gonna assess? I'm gonna give you pain meds. What would I accept? Bible signs? Bital signs of which one's particular? That's crucial. Reforation? Right, right? Okay, so why are, well, could, could giving somebody morphine, make their respirations be slower. Yes. Okay? But if we take their vital signs, their vital signs are normal, they're awake, and they're talking to us, giving them a prescribed therapeutic dose of a drug, is not going to, they're not going to be sitting there talking to you and then stop breathing. What we would see is a gradual change in level of consciousness. So we would see them getting, you know, more and more, um, or less and less alert, and then we would see some changes. So that's our cue, and that's why assessment is so critical. So we don't want to say, I can't give you this med because I'm afraid, you know, it's going to make you stop reading. Um, so some other factors here, and I'm not gonna go into all of them, because I want to try to get through here, but just know there's a lot of things that factor in. I will said, a big thing here is under treatment of pain for people that can't report pain. Whether that's, you know, pre verbal, non verbal, is a big one, and so there are a lot of pain tools out there, which people just like that. So there's the typical intensity rating scale. There's some scales for, you know, children and newborns. And even those with some demento, there's a lot of different scales. So we're going to talk about all of these different types of pain. Probably nobody knew boy George besides me, there was a song about, Do you really want to hurt me? Do you want to make me cry? So I think about that. Okay, so let's look at types of pain. First of all, in terms of duration. Acute versus chronic. So acute is pretty well accepted as something that has a duration of less than three months. So it comes on quickly, but it doesn't last beyond that time. And in many cases it doesn't last more than a week or two. Chronic pain is one that's going to last longer than three months. Then we're going to look at nose deceptive and neuropathic pain. So I'll leave that to the next slide. All right, the cute pain, which is also nosy septic. What does a cute mean? I said concert. Sorry? A recent... recent onset. It happened kind of quickly. As opposed to chronic, it happened but it's persistent. Okay, so acute pain is synonymous with a term that we're gonna get more deeper into, nosy septic pain. No deceptive pain has to do with nosy scepters, which are specialized pain receptors, but the key thing is that I love this. The N.O. in normal, in the N.O. in nosy sceptic. This means our nervous system is functioning normally. We're not having pain because of a damaged nerve, which is the case with neuropathic pain. So no deceptive pain made my nervous system is fine. This is the normal expectation of a stimulus that's causing me harm. Okay? So it's protective, it's, again, it starts suddenly, usually relieved, after maybe the inflammation. Or the stimulus is removed. Okay, and it initiates the fight or flight. So I'm jumping ahead just a minute, but what kind of clinical manifestations do we see in the fight or flight responses? activated? Tacking car, you know? Tachycardia. High blood pressure, and you'll see the others on the list. Up right, right. Some other things that we might see, and we'll talk about in our profusion lecture, if we might see some pallor, because blood vessels are constricting, and we always want to preserve prioritize blood to the major organs, so your fingertips, your cap refill, may be a little diminished, maybe a little pale. Your mucous membranes may be a little pale because we're prioritizing, you know, blood flow to the organs. But all of these things are what we see with fight or flight. And some behavioral things. Now, not everybody is gonna grimace and groan. Have you ever seen garden? Have you ever had garbage? Which is usually abdominal pain. So, somebody is going to touch your abdomen, and it's just a reflex, like, you don't even realize it, you're protecting yourself from somebody causing some pain. All right, so these are, and we're gonna compare a cue... That is one strategy. I'll talk more about as we go and study for this course. comparison, acute pain versus chronic pain. What's the differences? Nose deceptive, nose is neuropathic. So we're gonna look at that. Remind me before I get too far to the end, I want to go over our assignment for this week, which is gonna be due on Friday. All right, chronic pain. Less longer than three months. can either be considered persistent pain or could be intermittent chronic. It doesn't have a known cause, it doesn't really have a, it doesn't serve a useful purpose. It's not protected. Now, you talked about migraines, so you don't have them three months necessarily all in a row, but it's a chronic condition, right? Yeah, it can last up to, like, 72 hours, sometimes I have to go to the ER to get the medstone because with mine, like, even rescue meds, kind of don't help. It's a matter of, like when I get one, it's just... So hopefully at some point they'll take care of it so it's no longer in chronic condition. Yes. Which they have sort of giving me some newer myths that has just made it, like, I'll get a migraine every once in a while, but it's not necessarily one that lasts significantly. Okay. Now, here's the thing that's a little tricky. Chronic pain can either be nose deceptive, meaning normal processing, or it can be neuropathic. And here's the example, canter pain. So cancer pain is not nerve related unless it was maybe a brain cancer, but cancer pain can definitely last more than three months. So it's the normal processing of the, you know, the body's response to pain, so it would still be considered no deceptive pain. But if somebody has, um, diabetic neuropathy, or that had shingles. And so there's this condition called per post, per pick, neuralgia. Let me forget to silence everything here. Sometimes it met. Okay, so that's important. So chronic pain could either be normal or it could be nerve related. And again, it can be intermittent, it can be persistent. Here's the thing, though, especially when it's persistent, is that there is adaptation as far as the vital signs. So people don't continue to have that fight or flight. So their heart rate will become more normal, even if they're in pain. Your blood pressure will be closer to normal. They may not have the same appearance, and so this is why sometimes people look at them and think that they're not in pain. because they've adapted. So they, um, people, you know, fear like being labeled as a complainer. There's a lot of times they've sort of adapted to, they still have pain, but they may experience it differently. And a lot of times it affects their activity, their living, their activities that bring them joy, that they just, they kind of become preoccupied with pain. It's kind of looking to duplicate there. There's a... there's a chart, and we cannot hew there, and I printed that. Let me see what that was. It really was kind of interesting. It just talked about some other things that I had thought about. And here it is. It's comparing the by the source, the onset duration. Things like the significance or the, you know, just actions. So take a look at that table 15, 3, in either book. All right, this is what I want to make sure we get into is the neuroanatomy and the taco of neuroseptic pain and the patho of neuropathic. So, hopefully, you took a look at, I want to ask you to raise your hand, but hopefully, you looked at the pre class lecture. Uh, there's something called, There was a flight on ions and ion channels. So I, of course, are charged particles. Spent a lot of time with that in fluid and electrolytes. And it's necessary for them to cross the cell membrane to create a pain impulse, but in order to do that, they need some help with what's called an ion channel. I on channel of these protein type channels that facilitate them moving across cell membrane. And we're going to see how, in the patho of pain, opening those ion channels basically facilitates pain being transmitted and perceived in the brain. So one of the things we want to do is close the ion channels, so we'll talk about that. So there's pathways that carry information from the side of injury to the spinal cord, then it travels up to the cerebral cortex and then the sensory cortex. And again, no deception, normal. Nosy scepters are found almost everywhere in the body. There's not as many in the viscera, the stomach, pancreas, gobladder, liver. There's none in the brain. So we would think, How do I have a headache then? And pain is also transmitted through the scalp, scalp blood vessels, the meningi, so there's other ways. But most places we have, we have these specialized pain receptors called nose deceptors. Okay, so again, pain resulting from something not nervous system related, uninjured, fully functioning nervous system, normal processing, it warms of tissue damage. People would usually say it, they feel it as throbbing or aching. But what does it mean, localized? Does That's true. It doesn't radiate. And actually, if I said, tell me where your pain is, you'd be able to go. right here. It's right there. We know exactly where it is. As opposed to people that have abdominal pain or referred pain. Sometimes it's kind of like it's just sort of sort of all over. I can't really point to one spot. So localized means, you know, exactly where that paint is. Okay, so this is important. No deceptors are these pain receptors, so they're just kind of like on high alert, like, okay, I'm ready. If something's coming on, I'm ready to take action. So the kind of stimulus that would cause no deceptive pain would be mechanical. So, a muscle stretch, a fracture, a surgical incision, that's considered mechanical pressure. Mechanical stimulus. Thermal. I've got this slide here. A couple of, let's see, three years ago in August, it's really hot, and then in 2018, it got to 112. So, you know, it was so hot. I didn't want to be outside for a couple of minutes. I never realized the same was true of cold. I had a friend that had this cabin in Crandon, Wisconsin, and in 2015, it was minus 10 degrees before the wind chill. And so we would go outside for, like, 20 to 30 minutes at a time, and it actually was painful. It hurt. I never thought of cold as being painful. And then our snow pocket lives in 21, you know, when it was like, I remember the high one day was one. Crazy. I'm like, is this Texas or what? So thermal extreme. And of course it's sunburn or frostbite are kind of extremes there. Now, chemical is kind of interesting. Let's look at external first. So, hopefully, nobody's ever been pepper sprayed, but has anybody ever been chopping onions? And all of a sudden, you're just crying, you know? You don't know why, but there's this this substance called Alison that is in there that causes this response. Have you ever heard of Kepsay? Actually, it is a, it's an extract from certain chili peppers, and they make it into an ointment to treat, it's a topical treatment for certain kinds of pain. It's sort of like pain, helps pain. It's very weird. So if you look, I think people that I've known that have neuropathic pain would sometimes use cafe ascent. Some people do that in a drugstore. Now, wasabi, I had to think about that. I've had little wasabi peas, and I never, it's spicy, but I didn't think of that. as a heat type thing. So, we're gonna look at, in the body, there are also these chemicals, these neurotransmitters that are released, that cause tissue damage. So we'll get to that in the patho. Okay. So this is what you want to really focus on. These are the 4 steps, and so every time we talk about the patho of something, they'll always have a formal name, but these 4 steps. So here we go. Focus on this for your exam. So the first step is called transduction. We are converting a painful stimulus into an electrical impulse. So I slammed my finger in the car door. Okay, so in order for that signal to get transmitted to the brain, so that I, if I want, I guess that I don't leave it there in the car door, you know, that I know I need to do something. Uh, it has to be, you know, it has to be transducted. So, and it has to have an action potential. So, again, neurotransmitters need this action potent. Remember, there's depolarization of the cell membrane and repolarization so that it can move. Okay, so, there's painful stimulus. Tissue damage is going to release these neurotransmitters, and there's a bunch of them. Substance P. We'll talk about prostaglens again later in the semester with fever, but they are these lipid like hormones, or these hormone like lipidids, that cause fever and pain. So they will be released, and they're gonna enhance the impulse of pain. There are some other things. Last semester, we used to copy that asthma, but we moved that to the PD course, but histamine and luco trains are involved with inflammation and vascular increasing the permeability of the cell membrane. So what they're gonna do, when we have tissue damage, they're gonna amplify the experience, and it's gonna lower the threshold, meaning it's easier for the pain impulse to be activated. So it doesn't take as much for that, you know, for the pain impulse to be felt. Okay, so transduction is the converting of a painful stimulus into an electrical impulse, and it's kind of assisted by these neurotransmitters. We're gonna look at it. I'm a big picture person, and we're gonna look at a picture that kind of puts all this into place. Okay, so here's what happens. When those neurotransmitters attached to the nose receptor, the pain receptor, it opened that eye on channel so it could cross the cell membrane. We're good to go. We're not launching a rocket. We are go. We never go. The thing is, some of the opioid medications, you know how they work, they close the ion channels. So this is why I like to pull in in a little bit. So they're opening the ion channels so it can, you know, can do its thing. Here's the thing that I used to not focus on, but there is kind of a purpose to it. The two types of nose asceptors, there are that any delta, these are mildenative. What is significant about that? Move faster. So I call these the AT. The 18 is fast. And then there's the C fibers. The A team pain is gonna usually feel sharp and well defined. The sea team, the sea fibers, still got to cause pain, unmilinated, a little more of a dull, aching sensation. Remember the A team? Okay. Um, I've talked about the withdrawal reflex, and this is just a picture of that. guys. All right, so we now converted that stimulus into an impulse. Now it's gonna go somewhere. It's got to go to the brain. I'm gonna go this picture for a second. Really, it talks about three things, these neurons, they're kind of like escort. The first order, the second and the third. So I'm just showing that in a picture. Okay, let's go over here. Okay, so this is, like, the whole cycle up to the reception. All right, so we have the tissue injury. The inflammation, the relief of these neurotransmitters. So now, in transmission, it's gonna tread. I'm gonna travel up to the spinal core, if there's the dorsal part of the spinal core, it's gonna cross over. But it's kind of intercepted here by this personal escort neural. Okay, it crosses over. It's gonna ascend the spinal cord, and now there's a second order. An escort. I like to simplify it. Then it gets to the thallamus, and it's going to make its way to the cerebral cortex, and there's the final desert. Okay. All right, so it's got to go from the side of injury, spinal cord, crossovers, and go up to the salonas, to the cerebral cortex, and then it's going to be more primly, interpret the syndrome cortex. And now, the third step is perception. This is what I'm aware of. I mean, pain is happening, but I'm aware of it now. Conscious awareness of pain. Um. Just some kind of... other things, sort of assist the perception here. All right, so here's the term, threshold and tolerance. Threshold is the minimum intensity of a stimulus that's perceived as pain. I was with my cousin when she was in labor, one time. And I would see that she would feel a contraction coming, and you could see it on the monitor, it starts to go up, and, you know, many people would be just, like, moaning and very loud. She was like, Oh, my God, that's what I hear. Okay. And I was like, Wait, what just happened? You know, she had a hind tolerance. I mean, high threshold for pain. Some people are in a lot of pain pretty quickly, and some people, you know, we're all down. Her thresholds were pain, like the point at which it was suddenly kind of noticeable. Was her threshold? Pain tolerance really has two definitions. One is the greatest intensity that you can stand. Interesting that tolerance decreases with repeat exposure. The more you're exposed to something, the less you tolerate it. You don't do well with it. For a short time, things like alcohol conception, but also opioid mids increase your tolerance. Meaning you're able to bear it. Okay? So that all that happened with perception. There was our picture. Lastly, this is the good part. Modulation. This is where the body is going to do something about the pain. So there's a lot of natural regulatory mechanisms, but then there's also, we can give opioids. But we have natural indoor food. We have natural things. Okay, so, I'm gonna let you listen to this slot, listen to the lectures, all this, because I want to get to one other thing. Just to say that there's excitatory neurotransmitters, which are going to facilitate, and, you know, enhance the pain, and there are inhibitory sections. They're gonna make the difference. So these are the ones we know the most about. Indogenous opioids, so it's like endorphin, which are, like, a body form of dorphin. I'm gonna figure out what to do about the temperature here. So the endogenous opioids inhibit transmission of the parent. Hopefully this is first day people are taking pictures there. We just get a little bit better. Yeah. All right, so remember the endogenous opioids, they're going to close those ion channels. So what does that do? They don't cross the cell membranes. They can potentially stop then ever reaching the brain, which means we don't recognize it. I got it. And... in the spinal cord and mid brain, we have these suspects that will travel down to the body to also modulate the pain. Okay. There's some additional ones here, in Kefelens and diamonds. Um, okay, so they're descending, and there's, um... There's the ace in it. Now, something, we're about to talk about the gay control theory, so we're kind of leading into that. You guys heard it. This is a really important thing. The gay controlled theory. This is really closely tied to modulation, how we either prevent pain reaching the brain by closing the channels, or we release substances that travel down to the side of injury and take care of that. But one part of the gate theory is this. So remember, we talked about the A delta fighter, uh, alk fiber. So they're the A team, and they're like the Delta Force. Okay, so they're, like, intense. The sharp pain. This is the A beta fibrant. These are some fibers that can help close the gate and modulate pain that are, they're kind of activated by touch, pressure, and temperature. So sometimes things that we do that will help pain are like putting ice on something, or putting heat on something. Or, let's say you've heard something, and you kind of rub the area. You kind of massage the area, or even get a massage. So by doing that, it actually is going to inhibit the transmission of pain. So there's a couple of slides on the gate control theory, and I'll come back to this. And then I've got one simplified. Sometime, again, this is my AI health hair. So the gate control theory is this mechanism in the spinal cord that allows this virtual gate to open our clothes and either allow the signal through or prevent it from reaching the brain. So when the gate is open, the signal is like it's a free highway, it goes all the way up, and we perceive it, or if the gate is closed, the pain signal does not reach the brain. Okay, this is a cute little chart, I think. Some things we can do to close the gate. So, the spinal gate closes, if the inhibitory signals overpower the excitatory signals. What we just said, the A beta fibers work in those ways. The descending pathways are where we send signals, and there are transmitters down to inhibit those substances that cost the pain. And the things with the endorphins. Lastly, there's cognitive things. So the gate, meaning the pathway up to the brain, closes, if we do things like distraction, support, that can help modulate or close the gate. But if we're fearful, depressed, or stressed, and that tends to open the gate. Does that kind of make sense? Okay, so you may need to go back and look at this one more time. So we can potentially close the gate with either our natural morphine, our natural endorphins, or we can give somebody, you know, external, um, that, like, opioids. Okay, so then, again, I just put a slide here. How medications can modulate the pain? Opioids do it by, you know, um, walking, uh, so that, that they, they close the ion channels. The instants work a different way. These are, like, advil. There's an enzyme that is going to allow prostaglandins to be produced. We'll talk about this when we talk about fever. So the N said to block the enzyme that allows that. in the simplest terms. So this enzyme, the cycle often demains enzyme, allows prostaglandins, which cause pain and fever, to be produced, but the end said, will lock the enzyme so that they don't get produced. I see the medicine is not exactly an instant. They work a little bit different way. All right, let's see where we are. If they, I did not get to you, so this pretty straightforward type of no deceptive pain, kind of superficial or deep, the visceral pain, you know, like deep in the appendix, liver, um, there's not as many of those pain receptors, so people don't, you know, it feels different. It's not sharp, it's more cramping or aching. And this type will often be referred to another site. So just a couple of things about this. The 2 kind of really good examples about referred pain. When somebody is having a heart attack, obviously, their heart is here. Where do people typically say they felt pain? Right. Left arm or right arm? Okay? What's in other places? Like gastric? Epigastric? The jaw, the back, and the women have very atypical presentations of plan. Sometimes for women, it's just fatigue. Okay, so there's these charts here show where the originating organism and then where the pain would be felt. Just some slides about how important it is that we relieve pain, patients won't breathe as well. They don't want to move. So if you have patients in the hospital, they need to get up and they've had surgery and they, we need to get them out of the bed. We always want to try to medicate them before we do that. So they're not going to be holding their breath. They're not going to be reluctant to move because everything hurts. Okay, I just want to, I want you to, I want to hit the 3 high points here and then that will spot there. Neuropathic pain is when there is nerve damage. Let's see. So there's the kind of the classic things that we see here is something called hyperalgesia. With damaged nerves, We have something that has lowered the pain threshold again. peripheral sensitization. So, something that would not be that much of a stimulus is huge. And there's another term called allodynia. Our past book that we had spent a little bit more time on this word. I think our current one does, but they gave some examples. So in Aoudinia, the brain perceives something mild and painful. The examples they gave were being in the shower, and the water, you know, touching your skin would be painful. The sheet rubbing against your body. Or the wind blowing under your body. Something that most of us would not think was painful, but these nerve endings are just hyper excitable. It's damaged nerves. Neuroplasticity, the brain is trying to adapt, but it kind of rewires itself. Go how you are. And so then, there's either a peripheral neuropathic pain or central. This one is more like, you know, spinal cord injury. The peripheral is more like anime landing. Have you ever heard someone has an amputation? And even though the leg is gone, people keep saying, my leg hurts. That's blonde. There's some, possibly trapped, the nerve endings, but there's still some, there's, there's still sensing. All right, so peripheral sensitization, it's basically amplifying the paint signals. And then the patho here is the initiating event with the nerve injury or trauma. Could be diabetes, could be chemotherapy, could be shingles, the nerve undergoes changes, which makes them hyper excitable. They fire with that normal stimulus. Lowers the threshold. And in this case, here's the big thing. The gate stays open. So these are the steps in neuropathic pain. Well, we're pretty close to the end, actually almost to the end here. But I want to take a few minutes and talk about your assignment, and then I'll let you go. So, I know that we went through that quickly, but know that you have a pain from recording. It's a very pleasure. Mm hmm. So if you have any questions, I want to meet with you because we want you to come fast. Let me show you this is fine. Sorry. Mm. All right, so normally, they're gonna have a work sheet, too, at 8 o'clock on the day of class. Good week, it is, um... And I put a little thing in here, 'cause that's the original, not they had generated, so the same. So, here's the worksheet, and you're gonna, in the past, I had people handwrite it, which I think was good, but I couldn't be there for it, but I got back to time. Sometimes it was just small, you know? All right, so this is what it is. Read the instructions, have to be tied. Uh, the way I grade this assignment is, you know, you'd have to do a lot to not get more credit, but it could happen. So you have to answer these questions thoroughly in your own words. So, the pathophysiology of either neuroseceptic pain or maldeceptive, your choice. So explain the step by step process in your own words. And sometimes I'll say, okay, not to leave a complete sentence. Here, you're gonna teach the patient about their pain. in terms of making his understanding. Now we're gonna say, what body systems are affected? on half. Over here, we're gonna say, what abnormal findings, and what manifestations. What herishing assessive would we do? What diagnostic tests, what would they be, and what would be the abnormal finding? Now, with pain, it may be a little different than, like, an x ray or something, but, um... Well, so you can look at a lot of things. There's a lot of leeway here. Okay, and then, that's it. I actually took off the med part this time. And the other part, in order to get full credit here, is that you have to use your heater and a can't textbook, and just tell me the title of the book, the author's name, the year, and the page number. And one other source, which could be a book, a website, or anything? So to get full credit, I'm not even looking to see that it's 100% accurate, not if I'm honest. I'm just looking to see, I know, I'm glad at it. Does this sound like this is your own words? Did you talk in patient specific language? Did you, you know, thoroughly answer these, and did you give any references? They should be really confused, and they usually are. Any questions? This, I put this one due Friday night and night. That could be okay for you guys? All right, any questions? Yes. Where do you want us to add this vacation? Just down here at the bottom, and it's not... I'm not even really looking for APA format. You know, like indented, and italicized, and all that, just this. Time of the book, author's name, what year, what page? All right, guys, it was great to meet you. Relax. the next time actually after you Thursday day andoriation something. But you guys, you said, thank you for all you in to sure have. All right, let me know if you can't get to something that you do. Oh, my head. Did you see the other buddy? Yeah, I don't get enough. I don't understand how to read it. It's just a date. It's like how you're looking. So what are the X's? That's the day we're in, for adult jet, or financially. I don't even know... Well, she's like... Where did you fly? And then... Oh... Uh, right? Old car uses music. Everyone's parking now, because they took fire... It's, um... It feels like... This is the life run of the... That's... Oh, never mind. So, I'm kind of there, but, like, next week, we're right now. So, like, were you, this is a library. I'm the library. I'm the library. Not easy. So what is NDA? Monday, Wednesday? There's, like, four parking lots in the center. I don't think any of us have the same... I like MW. The what? I'm MW. So, each abbreviation is the location you're going to? No, what parking lot are you? It'll tell you what they... I'm like, bro. So you know... Go ahead. You know the parking lot that's, like, the first one we come in contact, that's not this one. Oh, okay, okay. The one across from Meyers. Not right or wrong, right there. Yeah. The Christmas studies? Yeah. Yeah, yeah. Yeah. Okay. I parked on the 3rd one. I park at the library. Bro, it's so hard to get a spot there it is. I don't have a stick. put my sticker on my foot. Girl, I just, I took someone's spot, they just got towed. Because they didn't have a sticker? I don't know. They had a sticker, but I don't know if it was an one or what. I don't know why she.... Maybe she did give me something. I'm going to hope. I'm doing crew health, 'cause some of us don't have the same ones. And we have them on different days. Bro, there was no snow. So he was like, yeah, that's our synchronic one day. And I was like, I'm so sorry. All the X's are adult gariatric. I was like, and then every other abbreviation, and then I wanted to... Yada, yada, yada. So, I don't know what he said. But I imagine it's, like, personal. I think she got... I think, probably, but that's really sad. At school, that's messed up. Yeah. HEM? I mean, if it... Bro, I cried. Dude, that's beautiful. Hopefully, they'll be in there, too. When does LAC? They better. Oh, yeah. I was like, I was the other thing... My brother's gonna take it... I want to get a ticket for parking universe today. I want to take it because I parked in, like, the white lanes. I did, nice. So, we go to these days. Oh, like, I went to... So, like... So, I don't have tacos on the 26th and the 27th, so. Oh, yeah. Um, and I went to... If you're assigned that date? Because we're not we're not assigned, you know, one every week. It's... Spreading out. Just right down the beach you go. Oh, I see where you go. Where? Okay. Sorry, guys, I'm stupid. So, no, it's a little confusing. The MW is, I'll go on September 3rd. I think it was. So I don't have anything the other day. Unless I have an X. Yeah. That's... Yeah. We don't know what POV is. We're trying to figure out because what everybody has. I'm sure she lives on work. We're brought in. Yeah. Well, she's trying to determine if... And then I'm like, oh, I'm gonna... Hey, we passed our... I was sick. I'm sorry. I'm so sorry. Oh, really? I have my... good job. Oh, my gosh. Thank you for reminding me, I need to sign up for it. For what? Yeah, I got my food posted. Mission train. Oh, yeah, I was thinking too late. character, and, like, what you're into... What did you want? Yeah, I couldn't do it any other time this week. When you just go, baby. Yeah. I haven't. Natalia, which one did you sign up for? Ecuador, Thailand. They ask you, like, what's your weight off? And then they ask you, what are they doing? So way off? With your laps. I want the one... I really want to... And, like, every second, and, like, one... Third one is in Thailand, and... She's already went to England. I mean, it would be nice. It would be nice to see, like, the hosts that I have last year, because I know they do it every year. That'd be fun. Like, you know, like... Yeah, it's been two years. Yeah. But, like, Thailand seems really cool. It's just, like, such a quopitory. Yeah, which is why I want to go to general. Like, that one is beautiful, brother. I was hungry in it. I'm hoping I feel like everybody's going for that one, but I mean, at this point, I just want to travel. It's really fun. What are you like? You do a lot. And I don't know if they changed it over the years, but like whenever I went, 0 my gosh, the drive, like to, like you're like, in the capital, that would be like your 1st 2 days, which would be game. and then you'd go to Kayambay and other, like, good old towns, but you go, like, up the mountains, like, up, up, up the mountains. And so, like, there's these two girls. And they were, to me, I'm just, like, down, I'm gonna... And I feel like if you go to Mexico, it's like kind of... Mexico, you go, you're in the high level. Exactly. And so, but that elevation in Ecuador is 3 times more than... Monterey? Colorado. So, like, it's, like, the elevation there is really bad. But like, I didn't feel nothing. So I broke out sick, and then on the ride over there, they got really, like, they were... It was funny. I was videotaping them. like, what y'all know about this? Because, like, how are you gonna get... like, I don't know. Yeah. Is it? They're extra, but... Yeah, I liked it. It was really fun. What do you do? Do you just do, like, blood pressures and, like, wellness exams or, like, get that one in this? So, we had, like, a pretty... I'm sorry, my eye for my contact is so dry. So they really did before. Um, you set a pharmacology, like a pharmacy? So, like, that's why we brought all of the beds, the... I think the 2nd one that's triage, you do blood pressure, temperature, and you're asking them, like, what they're there for. And then it's like MP. In the PA, in terms of raunchy, like, would see the dog. I would see the patients. We were just, like, kind of... I signed up for triage just because, like, that's all I knew that I could do the best in, like, writing down Ecuador. They speak Spanish. They speak 3 different types of that's like languages. majority of it, like Spanish, so I was like, kind of... always set to, like, cashing... But, like, it's really fun. I enjoyed my country. Except this one time I stayed in a hospital, like had bugs. You mentioned my friends were watching, I kind of just walked in. But like, it's fine. Like, that's like, bro, I guess nothing about books. No, but and I was staying there. And as long as it's not like, in my great grandmother's house, and, like, literally, a roach, like, I was just, and I just call something crawling. It was, like, on me, and I was about to... Every show? I literally bought it. That's like, I don't know, I just, I feel like that gives you a lifetime experience. Yes, but I feel like that's what makes me grateful for what I have at home. You know, like it just, yeah, for sure. I feel like sometimes we take things for granted and simple things like having a room for your head or, like, water. But it's not, I hadn't moved. Yeah, I had a lot of fun, and I met amazing people. Yeah. I highly recommend everybody. The only thing is because I can't do that stuff. I don't have pressure. I want pressure. I have to get sponsors or do something. Yeah, and, like, um, they'll do within your group, they'll do, like, um, view, the missionary, if it's just me, you know, who, my racing then, as a group, with Yana's side to sell t-shirts, that's what we did for, or we did t-shirts, part and sweatshirts, we sold them around campus. We went around Christmas time, so we did like more of a Christmas season. Well, for this mission trip, it's the same. It's around Christmas time, come here. And so, I'll have to show y'all. I think I have it. But it's like discolored and it just says joy. And it's like the... Trinity. It starts at the end. What's the word? Hey, word shows, like... Yeah. That's what we sold. And that gave us a lot. And then you self, you do your own stuff. In another scenario, I don't know. You'll take it to that tomorrow, calendar, September 3, and they're gonna, like... Enough. And if it's on this trip, maybe next week. I'm not even met it, but it was absolutely hard. Oh, good. Oh, wait. I mean, yeah. Basically, everybody. I know, we signed up for Ecuador, we said we wanted Ecuador, and we got it. But it's also based on like how many people are signing up for what? So, I want to put Thailand as my number. And then I... I feel like Thailand is just like a once in a lifetime. Yeah, that's their... Like, eventually, I wanted to take that trip, but shit, if I can take it here... Yeah, and, like, you do trip days, like, where you just do stuff with your tour guide, and it's really fun. What was your question? Sorry, I, I, it. Oh, no. I didn't know they had a post date today, too. Oh, the two perform, and then, like, who's your...? Oh, no, for ages. Oh, you Can I cancel, like, insertions? Yeah. Oh, I always... Let me freak out. Yeah. I mean, there. I was highlighted. Which is burning. In the morning, in the morning. I'll put it in the fridge, too. You're gonna have side, and then she was, like, something before... I was, like, sorry. Hello, I forgot. Still learning. Was it, like, the exact same voice for me? No, I have a retake? No. Not big, actually, no, but it was... very close. It was good. I think out again. It's under your ticket. Right. I don't like Chicago. Right after in the morning, so I, like, never... I was just saying about that. I feel like... She was going through it too fast. She was jumping from the slides, slides, slides, and then things that weren't even on the side, and then she would add her into the slides. Yo, what I started doing, because I'm just... Whenever she's talking about... I signed your own. Thank you. Yes, I'm good. I tried in Chattanoogie, too, and I just, like, screen, and I was, like, I need this flight, like, super excited. And it did, I understood it, so, like, I'm just gonna do this. I'm like... It's a lot of... I literally just said, and I'm like, I would talk. Yeah, I can hear you. Like, there was some stuff I tried. Yeah, she'd be, like, Remember this, remember this? When is your interview? Okay. Uh, on... I'm going today, because I... For what? Oh, shit, the hospital, anyway. Oh, no, I would start orientation. She's in nowhere around the world. Okay, I knew you had... Oh, that's where this... Oh, I don't know, we're trying to... Okay. Is this for all those? Is this for all those? so. Oh, we gotta be in clinical uniform tomorrow. Yes, I saw it. I wonder what happened. I've seen something, and this has found in Claudiac arrest, but people say it's a... I saw overdose, I saw that, and then somebody talking about her boyfriend. They're also addiction. Boyfriend followed her or something like that. Then I said your passion because her brother had died. Well, she was already suffering, like, postpartum. Yeah, she was like public about it and her addiction. Okay. We need to be in clinical uniform tomorrow. Okay. Bring alcohol pads. Hey, so, we're... So, all of your students are, like, I know exactly where you told those over here. happens. Okay. Ibuprofen in Tylenol? Like, I chosen in the morning and somehow, later. Uh, it's a cold show. Thank you. I would... I'm like, you know... I think you should go. I think I know. But I'll, I'm thinking your mom a little bit about it. She said, Oh, no. Oh, wait, should I use the water? Yeah, don't do that. Yes, no, you can. It's all the way up. Yeah, okay. I can have my password. Oh, my gosh, there was these two of them. When we were doing the thing... Yeah, that sounds cool. I had no self-awareness of whatsoever. They were just, like, yapping the whole time. I really wanted to be like, hey, like, we're literally in a lecture, like, beyond mine. Like, I get we're in a study room, but, like, where were you at? We were in the three rooms right here. And they walked in. We all brought into our sun room. Like, we had our own, and they walked in there. I was like, what the flip are you doing? Did they get that? No. No, they stayed in there, and they were talking, like, super loud. I could not concentrate. Oh, literally, like, yeah. Y'all could've gone to, like, open here. Loki, I love these lessons. Oh, the house, and, like, the zoo for something? No, they can. Uh, no, the Oscar is just... And then the lessons are due. For this class? Nah. Yeah, I was like, I don't think for that. Yeah, more. She was our new today, I went to Sunday. And then, footwork officially... We have a quiz for 18, but today, yeah. They're pretty good. It's like EAQ, right? It's not true Path. Yeah. yeah. So, like, I was just on terrible more trying to get organized. Uh, 10 days from my birthday is Friday. Yeah. So, you know, we do have... No, look here. I only have four. Like, four clinicals for this class. Really? Yeah, they all have, like, seven or eight. Boo, I have... Are y'all sisters? Who? Yeah. No, you're not. No. No, we're cousins. Yeah, we actually are. Actually, our cousins? Yeah. Okay, you guys look so up for you guys. No. Because it's so familiar. Because it's really not similar. Nice. Hey. I have eight. All right. Anyway, I don't know what feel maybe. Yeah, we have that too. I was really nervous. I don't know, maybe I do. Yeah, again, darker. Yeah. Yesterday. It looks good. I like it. I used Kristen S. Oh my god, I've been hearing all about it. Did you like it? I'm too scared. It was only like 20 minutes. I was too scared to do it. I need to tone my hair, 'cause my orange slash red... Do it. I did the dark golden brown. I could have gone... It's so easy. I'll do it for you, bro. She did it for me, and, like, Aurora. And I left it on for 30 minutes, because I looked at the reviews on TikTok, and it was too light. I was like, oh, look, we have black hair. So I probably do it after my birthday. So, yeah, that's why I did it, because I was like, I'm tired of, like, because you could see, like, my blonde coming back. It looked great. No, don't get a bunch of that. I was looking at the dust couch. But it wasn't like a bad... But it was bad. It was bad. So that's why I didn't. Didn't it last like a month? Yeah. That's why I did it. Yeah, it's like a gloss. Yeah, that's how I do that. My hair looks shiny. Yeah. Because I went with my friend Sunday. And then she was dyeing her hair. No. This is what I'm gonna order. Look, hold on. I try to wear a dress. They look studious. Like this? Okay, it was too big. So, what was that? Windsor. So I think I'm just gonna order. I need to look over on the ground. Yeah, you do, because... You're gonna go with me. This is what I'm gonna order. Right? I'm gonna try if I don't... And then, like... 'cause it's my golden slash silver birthday. So it's, like, I want to incorporate gold and silver, but I feel like gold is not gonna let go on me, and silver is not. What if you did like a white gold? Kind of similar to someone. I down to go. shopping. Okay, there's nothing in Austin. There's nothing. Like, I literally came home, like, I was just so frustrated because I was like, I went to, like, multiple malls, multiple stores, found nothing. How long were you up there for? Since the morning, so. 10 o'clock. Yeah, and I didn't get back till 6 o'clock. So, yeah, I found nothing. So, I'm like, I'm just gonna order something online, 'cause I did also wanna order this dress. But it's like, I don't know if it would come back one time. That one's cute, too. Where are you going? I don't know. I'm still, like, trying to get ideas to what to do on my birthday. Like, I wanna do stuff, but I'm not sure. You know what I mean? Like, I still want, like, I know what I want to do. But it's like, I need to figure out time, stuff, and all of that. Wait, when's your birthday? In two weeks. My mom got mad at me. she called me, so she's, like, so what are you doing for birthday? Nothing? She was like, what do you mean, nothing? You are not coming home? I was like, no. I said, I can't risk going home, because we haven't examined that following Monday. We have 3 exams that week. So it's like, if I go home, I'm not gonna study. And so she was like, okay, whatever. And then I was like, I'm sorry. But it's like, there's so many birthdays. Like, it's my brother's. His birthday's the 31st, which is on a Monday. My stepdad's is the 30th. My cousins is the 30th, and I'm the 28th. And we celebrated our birthday together last year. I was not the center of attention. It was my stepdad. And me and my brother were just there. So I was like, I'm not doing that again. That's how September is for me. It's me, my mom. No, me, my sister, my grandma. Like all back to back. Really? Hers, it's the 12th, 22nd. Okay, you're not trying to live your life, so I'm only going down for mine and my sister's. But I was... They cook. Why be quiet? Why did we get quiet? That was quiet. But yeah, I don't know if I, like, want to split. I was telling Francis, like, on the list, for example, people have all you guys. If I wasn't sure, like, if y'all would want to... We could just do something... Temple, Belton, and I could just do something on my Dallas people. Like, ad for sure. Plus, like, exams, like, I didn't want you. You got a planet? Girl, my birthday, and I told the sun. How many? Eight. For here? Four. Four. Oh, no. I got seven. Oh, sure if you want some girl. I'll give it to him. I want peans. Dude, blue hair. Thank. My friend hated really care.. I don't. Do you want, like, four? Yeah, not including, like, the sim. No, girl. One specific day I needed. They're mainly all in October. Give out. After in October and then one in September. What date does your land on? Um, The one in September is Friday. My October ones are on Thursdays. I'm so good to, like, a clinic goes on Wednesday. See, all my hero Wednesday. Oh, good. What? Wait, what day did you get? I got, for, like, a cute care. Wednesdays. Wednesdays? Oh, period. So did I. I was so excited. But then, Aurora asked Ms. Maltwalk about, like, our, um, our section. People, again. Y'all haven't gone? No. To the hospital? Me and Kinsey went, and we actually come to the nurses, and we were, like, until, like... Really? You should go. Go out there. What was your 1st name? Minus 4 north, it's neurosa. patients with strokes. Oh that's cool. I'm getting more old people, like, after surgery. My family... I'm so tired of, like, old people. You're not gonna get old over people. Imagine I do. Bro, they're gonna fall, and I'm gonna fall with them. I can't. I'm not strong. Just pick the youngest patient. I am. We should try to... Let me tell him, Jackie. Oh, yeah, SDC2. Yeah, they're gonna have, like, drink... And then I had STC 5. It's like MedSurge. Okay, what about patients recently? After surgery, right? Oh, that's one of my other ones, like, really loud. I have had lots of times. That's cool. Where are you at? The... 7 North? Six North? Something like that. And the 7th is world. But the nurses there on Saturday in the lookie room. They were. They did not look excited for us. But that was like a Saturday night shift, so I'm assuming I'm hoping Wednesday. I hope it's a comedy throughout the week. Yeah, that's true. Yes, sorry. Besides your last one... Yeah, the last... The first, you see a whole bunch of... The first one was... What was another? You should go up there. It's a 10 minute walk, bro. So... So you can't be there on shortcuts. I'm gonna have to go early. Y'all know how slow I walk. And then also, I was thinking, Kenzie. Like, had a shower thought? The people before us, like, higher levels in the nursing program are also gonna be theirs. They are? I would assume so, because they also have clinicals. Well, you can more. So maybe that parking lot's gonna get even more busy if you're interested. I mean, I would love to meet up. Imagine raining. Can I take a bike? I know, Mike. Actually, good tea. I'm dead. Those scooters, yeah. Really, something. Um, my roommate from sophomore year, she went to clinical Sunday during this raining, she came back, she was soaking. She was like, I had to work like this in the cold hospital. Oh, heck no. She's lucky. Could you relax, too, instead of my mom? Oh, my God. That's true. You are so lucky. No, 'cause I don't have days that you have. I think you can come pick you up. No, it's fine. I'm, like, right there, it's okay. I'm thinking, I had to wake up early, early. I don't. You don't. You're own. Oh, that's so annoying. I have to wake up at, like, 4.35. Oh my gosh. You have to wake up at six. Get ready real quick and go. Must be nice. Oh, I forgot the brownie. I'm really gonna have to put on my own. You're gonna have to. Because if you're late, dude, that's bad. And it's 15 minute grace period after that. I'm like, all right, you gotta be good at. And it takes me 15 minutes to get to a temple. There's no way I'm getting up, brushing my teeth and leaving. No. One of my friends fell asleep, like, Miss, like, had to wake her up. Dude, okay, but she seems kind of mean. She gives Mimi. Yeah, so... Are you ready for IV? No? Do you have ib first, or do you have each other first? I have IV first, and then I have EHR. Oh, so you gotta be here with me? Oh, yeah, got it together, then. We do? We're together. Okay, period. I just gotta set my alarm. 'Cause I stayed up to, like, four... Girl... I forgot about that workshop thing and I was like, oh, I gotta finish that. This one was a lot easier than like the 1st one. The 1st one was hard. She went through those lectures. Yeah, it was too fast. I need to go through it. I clocked out after she started talking about like the Colie thing. I didn't understand it, so I just asked. because you know I was UTI and then the other one? Oh, Polisitis. Yeah, whatever that is. I was like, she's going to fast. That time I called dad, too. Yeah, I understand. Yeah, I was like, same. Because I did UTI too. I've had surgery, so, like, I know, like, everything else, like, oh, okay, give me a couple more. I was thinking about you. I was like, I know she knows what she's talking about. Oh, literally, she starts talking about it. I, uh, told JD to bring my water. Yeah, I need to pull it up, whatever, and I was like, no, I'm hungry. I want brownie, so I like, shout out to caramel. When I texted it, I was like, okay, I realize I was that close. I was like, oh, take a photo? I heard so. I was like, bro, I can't stop. Like, she's like, I can't hold it anymore. Francis looks so funny. And I see fridge, you're like... I wish I saw. When you said, I started clicking to try to find Francis, and Francis was like... That's funny, because you were like, you're like... I was like, like, she's close. And then, she was in it too. She was like... No, I had mine where I could see myself side. I didn't even realize through something. I was like, oh. That was funny, dude. It was so funny. Honestly, I was I was clocked out. You could be in this area. And then you're warm, one than the other. We have no exams. Zero exams. Is there, like, a? I've always said this is, like, a... Yeah, no, that's not the nice place to practice for me. I'm beyond you, yeah. I'm not... I put on a shirt. I will. Yeah. Yeah. It's easy. Yeah, I'm definitely... No, I'm both. Yeah. The only one... Same. Fog, path, and... Oh, I don't try. I just, like, didn't learn anything the first... Like, the first date? You know what? 'Cause you already knew all that. No, because... It was just, like... It just felt pointless. And this 3 hours long. March 21st, April. I'm just curious. It all just seems like reviews. I'm scared for exams, because they're critically thinking exams. I don't know how to do it. And you're 80%... Yeah, that's good when she said that. She was like, Not another five is, she's gonna go. Yeah, and then when she said that, everybody was like, Bruh, I said Bruh loud. We should a boot... Okay, bye. Bye. Have a great day. And what? She's a bum, leisure part... We did it already. Oh, we did? Yeah. Fragile is... Did you? He used to work. y'all. Um, sorry. This is edit, I don't know, 649. Um, and I know that they're going to continue being mistakes on it, so we're gonna continue to work through this. Overall, it should be... should be fairly accurate, but if you see something that, um, fairly... Ouch. Not correct. Please bring my attention to it, and I will keep editing it sometimes all the way. Right. Um, we're gonna go through... Okay, stop... The sweetest... The lockdown browser, and everybody in here access the lockdown house. about that. Nice. See that? My contact is so dry. Okay, so go through class, and we'll go through as well. Make sure everybody's got access to everything. Yes. We'll take elegant big footage of schedule, and fix with these fixing. Yes, ma'am. Is our class start at 1:30 or 2? Because it says on the cylinder, two. But our statement was nerd. Oh, yeah, I... That's from the university, and... Well, we work with. We started one, but, um, supposed to start at 8 and... And one, but it has been bumped because we're trying to mirror global. This course, global is rolling out, is being phased out, and I'm absorbing global information. And so, in order to stay with them and some of the activities that we're gonna be doing with that course, and it's just a 2 hour in class course. So we're doing the we're doing 9 and 2 start. Yes, no. So then it's around 2 to 4, 2 to 350, yeah. Two to three. Come on. So we're gonna be going through some of the activities that we'll be doing with global, um, just to let you know. I have work. Good. you. All of the modules... And I'll just ask you a question... We're all... Um... Sign in sheets going around. Make sure you initial... Any questions right off the bat? Like five Okay. Let's just go ahead and hit up a simple syllabus. I'm glad everybody can now access it. And the lockdown browser, everyone can access that. And the reason why I had y'all do that is just to practice, because one of your assignments, you will be using the lockdown browser, and I didn't want you to, because it's that assignment, be like, freaking out, because you've never used lockdown browser before. I wanted it to be a smooth thing, and you just tank your, or finish your assignment in class, and then not worry about it. So, that's the whole reason, just to have it already set up so you don't get stressed out about it. Okay. Faculty, contact info course info, it's hybrid. So we're gonna go through, and y'all should see on your calendar, some of those days are in person. Some of them are, um, online and this is asynchronous. So y'all are doing your own work on your own time. This is not where we have to meet up in Zoom and do asynchronous, um, kind of course. There's a lot at this level for y'all. It's a lot. It's a whole lot. And so to have the flexibility of one ear plus to be do it when you have some time, um, I hope is helpful to y'all. Um, okay. Learning outcomes, the goal. Okay, the APA formatting manual. Um, you're gonna be using APAs throughout your whole time in nursing school. If you don't want to buy the manual, that's totally fine. There's plenty of online resources for you. But this is the ultimate say so. So whatever, whenever you get a paper that says, please make a reference paper, make sure it's an AKA formatting. This is what it's referring to. The 7th edition is the most updated version. And this, Elsevere, is supposed to be your information, where you're getting all of your course work. And everybody access Elsevir, no.ases. Okay, awesome. Your quizzes are going to open your quizzes for the following way are gonna open on a Monday and then they'll close on the following Sunday so that you have almost a week to get those quizzes done. The readings are listed for you, and we'll go through that. There are required lessons. Those are just required, because I don't think that everybody in here is going to read the entire text. And those lessons are like an abbreviated version of what's in your text. So if you read the required lessons, then you're gonna do fine on your EAQs and you're not gonna have to retake it a 100 times because you didn't learn any of the content. So if you love to read and love this content, like, I do, then you're gonna want to read your texts. And if you want the highlights, then you're gonna do your required lessons, but that's not for a great. The only thing being recorded as a past fail grade, um, are the quizzes, as far as a weekly assignment. You will have some other weighted assignments and we'll go through with that looks like. Right here are how all of the grays are weighted. I know there was a question on waiting and I don't know what modules were doing in that moment, but this is how each percentage of your assignments is going to add up at the end. So the weekly assignments, your EAQs every week, it's gonna be 25% of your grade. clinical components, all your paperwork, showing up, that's 25% of your grade. We're going to talk about the group project. We're gonna sign up for groups today, 20%. There's a dollar street reflection. I don't think that's the response lockdown browser. I think the cultural communication one is, but we'll look at that. Those are both 10% and then your final reflections to pursue. Uh, questions on any of that. Okay. AI, um, a good place to use AI is APA. Um, I'm just gonna go ahead and tell you. I'm totally fine with you using the 7th edition AP, but make sure that you're double checking that. Sometimes AI messes up and it doesn't do it correctly. So if you have your manual, then you can always check what AI did and, you know, some things are atelicized, some things need, um, 8 lists of authors and some need at all. So, make sure that you're always checking AI against what you're turning in. Um, the times that are not appropriate to use AI are like reflections. AI cannot reflect what's in your brain because it did not experience what your experience. So any reflections that you have are going to need to come from your own brain, that is going to be a red light, um, AI policy there. Everything else is a pretty good green light, yellow light. I don't want y'all being just copy paste AI people because you don't actually learn anything that way. Um, So I really do want help putting forth, um, your own brains into this, but for APA, right now, you're gonna do a deep dive with APA later on. This is just to get your feet wet and get you used to it. Used to what it's supposed to look like so you can easily catch things when they're wrong. Okay, course calendar, this should mirror your modules. Should be the exact same. There shouldn't be anything different. If you see something different, let me know. Now we'll fix it. Okay, so, first week was online, thank goodness, because y'all didn't have access to anything. All right, we're in class today, online, in class. You're gonna see down here these are 2 in-class days in a row. This is going to be where we're going to be meeting up with global. And on this day, we're gonna all be together in any C 105 because there's gonna be so many of us. So we're gonna meet together there instead of in this classroom. Um, and we're gonna have a guest speaker, come talk to us here and talk about things that will prepare us for the following week, which we're going to have, um, an in-class, um, activity. So we'll look at that in modules in just a minute. Then you got a couple on lines. online online. I think one of these is fall break. No? That was back there. Um, okay. Here's another in class with NEC. We're gonna be, um, pairing up with, um, global, actually I think that's this one. We'll look at modules. It will tell us. Um, and then this one right here is, I guess, speaker, and this week 16 says in class, but that's still up in the air. So... We're gonna play that one by your week 16. Everything else is going to be the way that it is laid out here. which should mirror modules. All right, so you'll see course content link. everybody can access that. That was such a mess. Okay, well, severe, yeah. Okay, everybody should have done the syllabus acknowledgment. If you haven't get that in. Okay, so the 1st this is worth 10% of your grade here, this Dollar Street reflection. I copy, pasted the link, and it is incorrect today because, of course, it is. So I'm gonna go in and fix that. But, um, the who link is correct, and then you're going to be looking at some families from across the country, so there will be a family, and there will be main, uh, labeled with a number, and then you're gonna just choose one of those families to do this assignment on. So, um, it is part of the Part of the World Bank organization, which if you're not familiar with that, oh, it's not. Okay, so the link is not working. Um, and it doesn't actually guide you to the families, but I will fix this link again and um, update that before your assignment is due. But this is the information that you're going to look at. And we're looking at social determinants of health. Um, those are the things that make y'all who you are today. Your social determinants of health help you go to school. They help you get a job or they keep, or they create barriers to getting those things. Um, healthcare. Just walking down the street. Do you have sidewalks that are intact or are people trying to run across the street and getting run over because there's not good infrastructure in where you live? Sometimes, you know, when you live in a place for so long, you're not seeing those things anymore and then you don't live in Belton. And you go to school in Belton and then you go back home sometimes you're like wow. I haven't seen that in a while. That does not look good. I see that in Belton when you're driving down like six, you know, they're coming to you, HP, and you're so excited. you're going to school. And then if y'all start living around, it's like, there's some things that are not that cute. Um, I think that belt was doing a great job of working on some of those things that, like, 5 years ago, even there were some things that were not, like, key on this road. So, and it's still that way, but we're working towards it. So this is just a chance for y'all to really take a deep dive about what your environment looks like, because that really affects who you are, what you can do. some of the things that are barriers. And so we're gonna look at all of these things for the families across the world. This is a global assignment here. So, So I get that link fixed, then y'all will have a not better idea what that's supposed to look like. Okay, so this one's due September 6th. You have a little while of work on that. Don't let these assignments creep up on y'all. I know y'all are super, so inundated right now. A student told me in the last semester or last class, how many assignments y'all had in your 1st week? Y'all. That's a bunch. Sometimes when we work on our little silos, this is much less, and I love my class, and I'm doing my class, and we are not seeing maybe some of the big picture stuff. But that is, that's a lot sort of outrageous. So I'm gonna leave it up to y'all to just kind of be the ones who say, hey, so much. Um, is there a way that we could maybe come buy some of these things or maybe not do some of these things? I'm only that, yeah, but I'm just saying, that's a lot of assignments. Um, So, we don't want to drown y'all. Like that's not the point. We don't want to be like, drink from this bar room. Survive or not. We really want y'all to be successful. We want to be nurses. We need nurses. Um, but I think, especially when we're rolling out this new curriculum, and I know y'all are gonna be so sick of hearing that, I said I wasn't gonna say new curriculum today, but I like. I just did. Um, that we're doing things that we think, this is gonna be awesome. This is gonna make my class so great. And all we're doing is just, like, loading all up of stuff and it's not what we want to do. So, just know that we're sorry. Please tell us, and we will get some of those things. That's another reason why I like for this class to be hybrid, because y'all need some space to breathe. Um, and like go outside and see sunshine, even though it's 5 degrees. We don't want y'all drowning. We don't want you quitting. We don't want you crying or crashing out, so, um, let us know. Truly, truly. Oh, my God. Communicating. Um, okay. Or is moving on through... Here we are in our first little activity. So this is week six in class. These are the two double in class days. Back to that. We'll have a guest speaker. There is going to be a pre activity assignment. This is something that y'all will. Oh, it's on. Thanks. Y'all are going to click this link, and it should work, because I really just looked at it last class. Okay. There are some horses that you're going to sign up for, and you're going to get a little certification that says, yes, I mean. I did this class, I passed this class. You're gonna bring these papers to class on the next day, and when we do our activity, that's gonna be your ticket and to be able to do our activity. that you are prepared and that you understand what we're going to be doing. So, again, this is all laid out in your module. It should be, hopefully, easy to see. Let's just go back and look at that. So preactivity opens here on the 14th, it's due the 20th. Make sure you submit that online on the 20th and then bring a paper copy. You know, I might do it. I might think twice about that paper copy. I don't want y'all wasting money on paper copies. Let's not bring a favorite coffee. Let's admit it by midnight. electronically, day before. And if you don't submit it, then you don't get to do the activity, and you'll have to just make it up. So, please, all right, if you really want to bring me paper, that's totally fine, but Saberton cents. on something else. And let's not do papers. Okay, so it will be due, though, the day before the activity class. So it'll be due that Sunday. We'll do our class on Monday. This cultural communications activity, you're going to be paired up with a AB1 slash S1. So it'll be you and that person in a room, in a patient room, and you're gonna be communicating or attempting to communicate with somebody who does not speak English. So y'all are going to be given specific assignments, and you're going to figure out how to communicate with them. How do you ask somebody who doesn't speak English? Whats wrong with them? Why are you here today? How do you teach them? Why it's super important that they take their diabetes medication or their blood pressure medication? Or, you know, maybe they come into the ED and their leg is missing and you need to figure out how did this happen? How old would you communicate with somebody? you don't speakish? So that's gonna be your activity. It's meant to be fun, an enjoyable activity, not like a silly game or anything, but I want y'all to take it seriously, but it's supposed to be an active learning thing, so I'm not just in a pair... fucking night off for tomorrow. Um, so that's what we're gonna do. that day. You will be paired up with somebody older than you and you'll have definitive objectives that you both will need to do for that activity. That's scary. Oh, let's see. Okay. Pre-stream activity, that's what we just looked at. The online tickets to get in, and then the reflection, uh, closed by 921. Okay. Make sure that I have that. Sweet, sure does. Okay. This is the one where you're gonna use the responders lockdown browser. So, you have, from the moment you finish your activity, last till the end of that day till 1159 to turn this in. This is the one we're granting it as far as because I want, this is a reflection. I really want to know what thing you're doing and I want to know what the experience is. I want to know how it changes your perspective on, well, you're gonna do in acute care when you're standing in front of somebody, and you have no idea what you're saying. And you have no idea what they're saying. So... Um... All right, so that is week seven. And we're mosing on. We'll break, yeah, everybody's gonna be so ready for Audrey. On October the 6th, I'll just remind y'all again. I think I talked about this last week, but it's October 6th is a Tuesday, and body of Christ has asked us to partner with them, for y'all to give flu vaccines to the people who frequent buying a price clinic. Um, some of y'all will get to do clinical and body price. That was my favorite. that my place that I love to volunteer. I just love it. I feel like it's, um, an excellent way to help people in our community. So if you are interested in that, I would love some help. They typically run anywhere from 50 to 100 people. There's just really there's no telling it could be a lot. It could be a few. I believe that, at least last semester, there was enough flu vaccine that y'all could get yours to without having to pay the $20 to nurse paying. But I don't know that that's going to be the facts because it all depends on funding and that's another thing we're going to talk about in this class. Kind of boring, but money has to come from somewhere, whereas the money coming from. Who's the one getting these supplies? Somebody has to report the effort to say, hey, I have this money. Let me fill out this paperwork, and when there's things like vaccines, that requires a lot of, um, red tapes. In a couple years. So, if you're gonna be around on that Tuesday, and you don't mind spending some of your fall break, helping us out, I would love reality participate in that. I always bring an ejective pad and some syringes in saline so the truck can practice on that. Because you know we haven't done in a while and kind of get resting. and I can kind of make it a little nervous. So, um, we'll practice before we actually... immunizations to people. I will send out that, um, sign up sheet. I haven't done that yet. I figure we'll just do baby steps and we'll fix this 1st and then we'll do things like shots later. Okay, ball break. Finn, this is our in class day, where y'all gonna do your class presentations. This is gonna be part of your, um, group work. And everybody loves a good group project. Nobody loves that. I know y'all. I am not a fan of group projects either, because literally every time, either someone who does the majority, if not all work, and then the others that are just freeloading. Um, and that is the way that life goes, and that is the way that nursing goes. But we're gonna practice not doing that to each other. So when y'all are out there on the floor as nurses and you see somebody who's on fire over here, don't be like, I'm so busy, charting. Get up and go help that person. They're drowning. Um, it's one of those, I scratch your back, you scratch mine, had a situation, and if they don't return the favor, then that stinks, but Jesus is proud of you. So, get up, go help people. Um, don't be that nurse. That's just like, they're having a bad day. Go help them. Okay, so the group, the class presentation, you're gonna do your group project, and then we're gonna present in class on that day, and then y'all are gonna do peer reviews on each other. And that's not just for you all to listen to another group presentation, but it's to help you get the full picture of social determinants of health in one community. And we're doing Belton, because we're all here, so you can drive around and look at what Belton's about. And if you're from here, then maybe they'll give you a little bit of a different perspective on your tone. Okay, so let's take a break for just 12nd and come down here and look at this group project. So it's at the very bottom because there's quite a few pieces to it. Um, this is just the paper telling you about it. These are the sign up sheets. I'm going to pass around sign up sheet now. Make sure that the group that you get into, that you like this person, and that you still want to like them after this group project. Sometimes it's not good to do this with your best friend or your roommate. Because y'all are not best friends or roommates after a group project. So think about it when you find out, make sure that it's gonna work out for y'all. Do people? We're good. Oh, I'm sorry. Yes, how many people are in group? It'll be 6-ish. This is a smaller cohort than my morning. I believe. So, it's gonna be around six. So let me go through the instructions real quick, and then I'm gonna put that paper out here, and let y'all stand up for a minute, and, um, stretch, and sign up for your groups. And then we'll move on into, um, aspect. What is it? Did everybody sign the scientific different today? cute. Okay. Okay. This group project is gonna be about social instrumental health. Um, did I get you good? So we're looking specifically at Belton. I thought I'd say that off pretty good. What is surrounding Melton in Melt County? It's gonna be a 10 to 12 minute class presentation. You'll make sure you kinda work through it, time it. Everybody's gonna get a chance to speak. So, um, if you're the intro person, you got a lot of good energy, then you be the intro person. Just make sure that it's divided evenly so everybody. gets a chance to speak and you're not going over that 12 minute mark. These are the 5 groups of, um, social determinants of health that we're gonna be looking at. Each of you will pick one of these. There are 5 total, 6 times fives, 30. I don't know how many people are here because you all are smashed together and my people, but we'll find out. Okay, so it tells you everything that you're gonna need to put in here, and there's a rubric here, also, just follow the rubric for all the things in this class, and you're gonna do totally fine. So that is due October 11th. Let's go back and look at that. module. Okay. October 11th. Okay, there we go. So you'll submit it by October 11th, that Sunday, and then on Monday, you're going to be actually doing the presentation in class. So, you're gonna want to make sure you're trusting professionally, and you don't have to wear a suit or anything, but, um, maybe not where crop top or PJs. Um, that would be, we're gonna practice professional presentations. Okay. Let's halt there. Let y'all stand up. Let's sign up for this. We're a project, and then we will... Honestly, moving. When you said that, it didn't spray me. Oh, my God. Yeah. I did not... I knew I played it off well, thanks. Well, we only got three people. Economics? Really? Like... I don't know. We're almost sick. We're gonna be able to sign up. Six, seven, eight. Oh, no, it was gonna have for advice. Okay, well, you guys do that for me. You're not gonna be able to do this. So you should call my name four letters, and it's N H O O R? And no R. Oh, yeah, that's fine. Did I tell you, that's my go to name, whenever I live? Like the South side. Yeah, we'll just... So, you wrote my, what was it? Crystal was a... They did K? With a K? wasn't there also a wine, then? Is it? I have a lie. There's an eye, there was an... Are you moving? How do you spell crystal? Shut up. You don't what I mean. apparently. Oh, my God, I'm so overw. No, Mommy. I didn't even hear you say anything. You're good. But I just like that one, 'cause we just all assigned. Yeah, that's what I would. Why is my chair so dirty? Like, what is wrong? I know. I'm good. My cousin, she went to... She went to Lavic. She used to go out a lot, like a lot, and she just texted me, sister. She was like guys, I'm so. I need to go to college town now. She's all right. Your cousin goes to love it? Oh, she just graduated, yeah. That's where I was for three years. And was she in January? Oh, really? Did you like it out there? You would have. Oh, I got the dumb baby. Don't you dare? At the time, I didn't. But being here, there's there, it was so much fun. Really? I would say... It's fun, but it's boring out there. I hate it. There's nothing to do with that, but there's no signature. There's so many bars. Yeah, stars are good. Tough tier. Ball games are... Yeah, football games are fun. Baylor with them? We used to have, at least, two parties every week at my... Wait, you don't make them? I went to my... And they were like, Oh, I'm gonna say, I was like, You're really mean? Okay. I'm here for a meeting. She's from the same here, especially compared to Houston. Love it was funny. I could not log in. I was telling my daughter, like, okay. cute. No, I have really, for me, does the thing where she'll, like, come and she'll sit, like, in front of me, and then we'll leave. No, no, no. I don't know what it is. Wait, is this an omelet? Francis too? This one is. Okay, bye. Um... Compared to... Oh, I don't know. It wasn't overdone. I missed it. It wasn't. It wasn't. And then she had gotten party... She had a kid, did she? How many? Art Sunday was, like... Because I know she had lost, she gave custody. Oh, yeah, she did give away custody. You're right. That's so sad, Dad. I wonder what she took. Like, was it? Was it real? Like, did she mean to overdose? Like, was it a suicide? Oh, like intentional? Yeah, or like, was she just taking drugs? and being scared to everything? Like, all right, we're doing... Wait. Mallory, were you in the nursing program? Was it hard? Because y'all had a day in the summer, too, didn't you? During the time... So, whenever I first saw them, my first class number in fundamentals... Which one did you say? Oh, you want to take that car? Oh, you having it? Okay. So you'll be like... Okay, I was... But at the party, breakdown... It's okay. They're, like, a lot of guests... They're... We have three people. We drink your group? Yeah. Okay. Yeah. Me, Kate, from Carolyn. We have three. Okay, three. Okay. Yeah. Perfect. Sounds good. But, like, comparing this, this is so much better you learn. I've already been not... But I love your scrub. I love the rub. I have the cute. You know who? Got tea. Yeah. Highlights your name, I'm sure. She, yes. She started working for her. Oh, where we could... Oh, I guess you're gonna just, like, you know, whatever's left. They said them already? Then differently, where somebody put their names down. I got it, right, though? I said they were gonna be in our group with three. But somebody wrote their names in our group.. Yes. I... I want to go put there... I love. It's really to work from here. Would you? Yeah. absolutely. It's true. You've not heard of this. Some of them are not full day scheduled, so if you're like, Oh, my gosh, I have eight days. Some of those may be half days or maybe I just overloaded you from his eye. Having a really time with this thing. So, if you have, like, 11 clinical days, highlight your name, put the number 11 next to it, and I'll be like, she's gonna not go to a living room place. Or three, that's not enough. How do you be supposed to have? It should be around... Sorry, I said that. They should be around that. You know, I definitely don't want to look it all up like... I'm gonna try not to do... Yeah, a lot of professors just, I think, I mean, not one. One community a week. Okay, I have my goal. And it should not be three. It should not be 11. Should be somewhere around. How many years? What if we have eight? Can I give that one that I beat off without? Like, I need that one out. Just kind of like your name. Wait, I think we already have fun. I just feel like we didn't eight. Garcia is fine. No. Oh, for so long... My friend for so long. Oh, at the end of the time, the semester, you have no other stand, actually. Are you in a cute character? Yeah, yeah, yeah. But you And then, Bobby, could you manage your name? Yeah. Yeah, let's talk about that one, but tell me... Oh, I'm just highlighting the number... That's the poverty system, so not poverty. He has some... Then, because that's... Okay, so Just count everything up. So don't call, don't call, don't call. At least. Oh, that's what POV means? It was me? Poverty? Yes, the pub nine. Oh. What is that? Point of vantified. Why, no, she's... No, just kidding. don't know. It's like a party. I was like, oh, no, I don't know. Do you highlight your name, the number nine? It's kind of fine. Ah, I can't get lost. Oh my gosh. If you take this from me, I will try... Okay, too hard. Just draw hard around the one that you love so much. Could I put...? Oh, see, like, an endo? Yeah, I know. Um, they see your name? Thanks, Benny. I don't know. I'm just talking to her. Can we eat? Yeah. Yeah. You only have four? I got seven. What did you say? Yeah, but it's for other people to see because you can't... Are willing to give it up or whatever? She needs an email from both of us directly. That was my... What are they? Um, so I'm at the Cardio Guys Clinic. I want Endo. All right, y'all, so we need to switch gears and talk about the food. Let's go. Overall, everybody should have a scene. It's everywhere. You do not have a CH? Please highlight your name and put CH next to your name, 'cause I need to give you one. Everybody should have a POV in the poverty center. That's the one I need, also. Your other zoos are... She could probably move the day. Not part of what you count for. You need around six to seven ish. Um, community, politicals. If you have absurdly more or less than that, then I need to know, I like your name. Tell me your number, and I need to give you some more balance. Yes. Bro, she's taking a question. No. All right, the Franken... Yeah, Franken. highlighting. If you love something, then you need a little heart around it, and I won't get rid of it for you. Yes, I have clinical on the stage, so what do I write now? On which day? Uh, Wednesday, the... What do you have in place of it? KISD? Okay. Highlight it, and put acute next to what you're highlighting. That way, I'll know why you're highlighting this. How do you care this day? So I remember... Have you looked at it? Um, not really, no one. You're really cute. You're makes. Okay. Yeah, what time is it But you can't just go ahead and handle your name. Highlights my federal health, and I'll see if I can... And how is that? Um, I do, like, if you're both good with it, it works with everything else, that's email me. I don't think your name is, and then, um, yes, I think to me, no... Okay, I'm sorry. I just... I don't know.. Okay, if you see TISD, whichever one should have a TIS. VISD or K-I-SD? That is Troy, Melton, and Colleen School. I, y'all, all have to fill out a background check. That's a requirement of the ISD. So, I need to know what school you're at, and if you're at, like, all three schools, and you're gonna put your neck on all three of these papers, but I need to give them a list. You have, I have to give them the list of your names, and then they see that you filled out the background check, and then you're not a creep, and that you're allowed to be in elementary school, and then they assign you a campus. I don't get to decide you the campuses. I'm sorry. If you're like, I want the high schooler, I want elementary, I don't get to decide that. They tell me. And then I tell you. Y'all, this is a whole lot of moving pieces, so if it feels like a hot mess, I'm real sorry. I'm really trying. Um... If you are a Troy ISD, these papers are here. What are you wearing? You need to fill out one of these before you leave today. Everybody, I think, should be filling one of these out. Should we just... And leave it here. Don't play, why are we here? build this out here.? I have to give them a whole list of everybody who's coming to their campus. What the hell? I didn't... Yeah. Gee, this one? Yeah, it's only... That kind of a lot. Literally... You could be. Uh huh. I hate to, be good. Probably like something. your name. And you put the number that you have... You don't need that. No, I'm not. I mean, the... the only Troy. Only for toy. These are good. For Belton, there's another process. They're all gonna walk in. We are gonna look at that. Oh, wait, I need those papers. Oh, I would have heard it. Oh I left my phone. Yeah, I need to take your mom. Hello. I have my interview. All right, you'll see in your modules here for students attending VISD or CISD. I'm still even waiting for confirmation for an AIS. What am I looking at? They have not responded to me. Because she said I could... I don't have it every year. There's a new person in charge, and... I have not heard from us. But, Belton, you're gonna click on this link. It's in modules. Click on that. Did you see what Krudea? I haven't... You're gonna follow these instructions, go online right here, and it looks like you are applying for a job at the ISD. But this is you right here. So that's only for Belton, right? This is only for Melton. This is the way Melton wants to do... My crew health is on September 10th. What about? So right after our critical day? Oh, it's just a piece of paper. We all fill that out. Cute. Yeah. Oh, no. Oh, I should be here. Because that would be on a Thursday. You'll find this in mind. We go to, like, right here. Follow this. They'll tell you what to do. I Are we...? Yeah. So we switch our crew house. Okay. I don't know. Heard from Honda is September 10th. I'm still that DSW for laptation. She would go to my location, and then I'd just go have food. If you have a crew health, did you have it for health somewhere else? Um, because everybody has to do frugal. Do you have one? Just that day. It's not a day that she can take. Basically, you'd have to switch somebody else's cur health thing. So, when do you have yourself? I have it on the 10th on Thursday. When you have your life T-shirt. So that would answer one of our... So you would have to get, like, a crew house with somebody to swab. But the... I was, like, running a sprinath on her... Right? It's not I know. This is how the whole schedule is. It was so... So it's... I knew... I would say, on the way that y'all wanted to switch five minutes... You're not supposed to have anything. So, you would you would just go to her crew, and then she would... Okay, I get it. You know, I really understand. Oh, no, general. How hot is that? It's like... Roof. I don't know, I was little. Yeah, yeah, yeah, yeah. Well, my brother kind of, like, for some too much. Can you look at me? Yeah. I thought she said she needed a crab. Oh, you like this? Okay. Oh, okay. Did anybody ever get, like, injured? No, but what was crazy? They have, like, power lines? Like, they were like in the backyard? And he was like, oh, yeah, we almost, like... Oh, my gosh, now you're going, and then it's... Yeah, nice to know your brother. I don't see I don't see her having a crew help. She doesn't have one? Like, I have my eye on you. Have you seen the WC? It's I... She says her house ends it. No, it's very... It's very important. Make sure you all have, like, room health and make sure you have... Everybody shouldn't have a T.I.N.D. Is it also the point? Part eight? Oh. We only need it there for lunch? Only for, uh... Like, I've been doing belt and let's go. That. Here is not, but no. Hey, I'm fine. Hi. I need your driver's lunch. Yeah. Well, you're home, probably. V I L L E G A S. And, like, it just kind of sucks, because, like, my sister's clothes in it. Yeah, I appreciate it. Everybody should. They are taking so many students. Yeah. Everybody should... Okay, turn twins. And if we don't have one, then my cousin's the oldest girl. Yeah, if you don't have your driver's license... Can I see yours? March. I don't like it. It's all Wednesday. I just have to use it. Girl, it's not two.. That's, that's helping my brother nephew like that. She was, like, the oldest girl. Um, what you're... It was cute. Because, like, I know... All right. The clinic law review is here, so... Make sure that you're understanding that. Do you have any problems, questions, whatever, please... Listen to me. Have you heard? Text me, 'cause I don't always get to answer phone calls. You could always tell. Can I put? You know, apple... For what? For my brother? Have you ever filmed? Um... Have you failed? No, no. Okay, but now there's no... I thought rice you would put Hispanic at missing... Oh, girl, I don't know. It's the other way around. Race is the color of your skin. And then your ethnicity is where you're from. Spanish? I'm white. I see that from my... Driving scientist. Okay, question, is that an ordering? It is. Is it working? Are you kidding Yeah, it is. They have, like, different, like, you could do different companies. Oh, on it. This was a gift, though. That's one thing. But I won't get one. Low key, it's low key, it is worth it. For me, literally, they brought all these problems... Uh, if do we say NA? I know, I was gonna put that away, but... I thought, like, in and applied. Like, right? I don't know. I already started. We haven't started yet? I'm just going right. There's kids in, like, you know, like, five to seven to eight. Ethnicity? I feel like that's kind of... Like, you probably think I'm... What? So you probably think I'm done. No, girl. Have you have trust, I have this conversation at least once a year. Have you ever put? No, I haven't... Can I just put NA for all of this? Would it be NA or no? I'm already writing note, so, well, I guess I can just put slash in. I put in A1, no. No on the other? I'm gonna just spend... I don't think the same, right? So it's just, um, everyone should be in power. We're just trying to... I hate that I'm on without that, though, for my nieces and nephews. I hate that. Yeah. Yes, thank you. Bitter juice. Yeah, I mean, I mean, eavesdropping. I don't know. Like, my oldest... It's a great number.. Sorry about that.. Oh, thanks. Okay. So, like, it's not warm with your dent too? Do you have to write this at the top? Oh, yes, yes. I'm gonna go put this in my... Sorry, buddy., are you done? If you guys are done, I can put stuff over there. GRG symptoms. Wait, what? Yeah. Thank you. Do you have to put that there? I just... Okay. I'm really just... Okay. I just don't want to just bounce back... Great. Let me get back to you, honey. I'm pretty sure it's done. Yeah. I'll get back to you.. It's a what? A garden? Yeah. Remind me of when this is... Heart rate, procedure Oh, my goodness. Oh, I don't know. Do you have a sideways? That is your favorite. Okay, that makes sense. Yeah, can I just... Actually, I wanted to highlight mine. Oh, I highlighted it on my laptop. Yours, I highlighted all three of ours, 'cause... me, I was thinking... Yeah, I got, um... No, I could take a picture of it. Yeah, yeah, yeah. Let's see what she said. Yeah, yeah. I thought I was... Yeah, yeah. I don't know. Reject this.iled eggs And I don't know, God knows how. My gosh, okay. I was like, what? Super... The more nutrition. I just washed the plate. What the heck? My laptop cut off. Hold on. Who was there? Is she kind of, like, managed? Oh, and I'm still... You still left? I'm a little mad at you. Oh, my God. Because if you're a joke?? The pool today? Uh, 17th. Uh, she says... What day was it? Um, what day is today? 17th? Yeah. I don't think I blink. I only want another one. I know, I just told that. I didn't understand. Oh, my God. Wait, wait, I didn't even understand what you were saying. I knew you didn't. Bill, Bill, Bill, Bill. I said, what day was it, Francis? Oh, I didn't want to ask. I didn't want to tell you. But in front of me, you would just, like, lean back and put your body weight in. You know what? It's fine. But anyway, I'll just have to go. It's fine. You could have done like for that. Once you, like, it's a really important document. plug in right now. Wait, just do it. Morgan. You'll find students attending BISD or TISD. Could they call them that in your modules? Take three. And you're gonna go follow these instructions right here? and you're gonna click on this link. Let's just go ahead and do a arrive right now. What class is this for? Popular. Popular... Popular... The T I SD, you have to fill out your bedroom... on a piece of paper, right? Oh, that's for... You don't fill these things out, y'all don't need to go to clinical, 'cause they're very strict about that. They should be. You don't want your nose around our children, so... Not the children. I don't want to be around. Yes. provide hours of observations. Just put, um... open. Oh, it's in here? Or you can put eight. Oh, really?. Yeah. Okay, what am I doing? If you let me out... This in green. I don't know. Is that the whole thing? For real? Yeah. Yeah Okay, thanks. All right. I bought it. Wait, so do we put a flight? Why are you doing that? For belting? You go to belt. You run above? Yeah. I don't know. Yeah, I don't like it. Miss Long, are we putting apply for? Are we putting apply for select program? Selected program? Sorry. You're putting a... Right, I don't know. You're observation, and then, yes. Apply for it, and that's how you get into the other. Everybody able to access BISD? You'll have questions about that. So you see... click on this. Yeah, just follow these right here. You're gonna go to available jobs. It looks like you're applying for employment. Apply for selected position. Observation hours... Or nurses? Oh, students. You're gonna upload the syllabus that's gonna be your recommendation or your school letter. Student teaching. Want to make sure, before y'all leave this building today, that all of these are submitted. Because we can't move on to the next buck, you can't get assigned to campus until I have days to the nurse. What are we actually doing there? Like, at the school? At the nurses? At the school? Anything the school nurse does. So that could be... So we're just following it in there, so. Mm hmm. Yeah. Yeah. I didn't know, like, exactly. And some of those campuses have, like, kind of medically fragile children going there. Like, they do so much more than back in my day where it's just, like, give somebody Band-Aid and an ice pack. They're, like, doing two feedings, and... Oh, really? Ooh. Changing diapers and... No it's mine. Oh, my shirt. Like, some big stuff, giving medications. Yeah. Yeah. There's some... pretty, pretty acute kids. So, then, we said, like, toy ISD, are we going, like, to the junior high high school elementary? They'll tell me, and they'll tell. Okay. Okay, yeah. And then that way, you'll know which campus you're going to, and then all of the, uh, the bell schedule is... right here, and you'll know what time in the address where you're going, but, uh... Yeah, I don't know yet. Okay. As soon as I submit all these papers now, then they'll tell me, and then I'll let y'all know. Okay. Your driver's wife, huh? My driver's name? Oh, That was a good question. No, I have mine. When you go to an ISD, no matter which one it is, you need to be in purple scrubs, you need to have your name badge on, and you need to take your driver's license, 'cause they're really strict on who they let into schools as they should be. So we'll make sure y'all have all that. Most of the side she'll go to for a community. You are gonna be wearing a purple scrub, just like you will for a cue. Some of them, you will not, helping hands is one of them. Do not wear your purple drugs. You need to be wearing jeans, and a UHB T shirt. Oh, you can watch T shirt. Tori, the shorts. It says on the breakout. Yeah. But then other places you go to, you're going to need to dress more professionally. Don't go out and buy anything. It's just whatever you have that is not scrubs and is not PJs. That's what you're gonna wear to those sites. In each of the briefings, we'll tell you what you need to be wearing. So, you're gonna go here to community clinical site briefings. And each of these has a different, um, different information. The only one, I think that is missing, because it's a brand new location for the semester, is health. If you see hope on your list, that's hope pregnancy centers, and I'm super excited. We all be able to get into that. Um, absolutely not. That is a, uh, a very can be very emotional. Um, some situations can be a very difficult and emotional, um, thing. So if you have concerns or questions about going to hope, um, please email me or come by my office and we'll chat about it. Some of these ladies are not really sure what they want to do. Um, they are, they didn't plan their pregnancy, and so it could be a very, um, it could be a really difficult, um, interaction. So they're going to let y'all know what their mission is and their stance on... Pregnancy and, um, if you have any questions about that, go ahead and look at their website and read through it. I'm doing it both of them to get some of your questions answered, and then... They're not course... reference the letter questions. What? We only have one site this fall, but in the spring, we'll have three sites. with the hope centers. And so we'll be able to open that up. I haven't gotten to that. They take volunteers too, so if that's something that's on your heart, then you can contact them or talk to them about it while you're... So that's gonna be hoping I'm going to be making one of these for Cola. Good point, hard to get exactly from my house. Yes, so I wanted to... The traffic is terrible when you hit... No, no, no... Put a... It's typically an eight hour day. It may be the last of us. Sorry. This one is asking for a reference letter. Yes, so you will put your to this thing. I am stressed. Um... Who is that? Hi. Hi. Um, it's your recommendation, or your school letter, that's gonna be your silvage? Okay. Okay, 33 of them. Okay, thank you. You're welcome. Three much students. Is there another question? Yes. It tells you. Sorry, not student teaching. Don't listen to me. Oh, gosh, I'm in the general... What? What? because I don't know what... We know that, either, so I put an in. Could be anywhere from elementary. I think it's like eight. Mm. I thought of John. Oh, my God. One other question do y'all have? Dude, I did so careful. I didn't have a word on campus, but I have to like to hang down. I put... Or junior high school? I wouldn't go into high school, but don't get bored. I know. This one's like your ugly one. No, no. I was like, it's crazy. Actually, your mama. Do you, technically, I just feel like, I don't know. I would be like.... For TCC and BOC, would you be worried for that? Um, Scrubs. Yeah, okay. Middle or... I need to down the syllabus. Okay, I'm in middle school. Let's Disneyland. Pre teen scare me. How long you won't allow us to download the syllabus. You're having so many downloads of syllabus. No. It only allows me to print it. Oh, okay. Go to print, and then save as a PDF. And then you should be able to upload it that way. Francis, I have your birthday in my house. And he is... And he is... Yeah. How do you know what, important for clue help? Did you find for? Yes, I did. Grace, is this, like, the morning or, like, afternoon? Oh, I'd be like, okay, yeah, let's talk about her. So, let's go to... her house has her own little... Yeah. Place. Okay, so for crew health... love. There's a briefing hidden in here. And this is a 9 to 3 o'clock activity. Um, so, there's gonna be a group of 10 ish, or there will be, of each of you. And some of y'all will be on Thursday, so we'll be on a Wednesday, just depending on where, pitch in, and we will meet in a room that is not listed on here, 'cause at the time, I didn't know the room, and now I know the room, so I will put the room on. I think it's on the third floor. I don't think it's, I don't think that's the one that's available. So, well, all meet together in that room at 9 o'clock, and you will come prepared, you're gonna wear your scratch, you're gonna have your stethoscope and your blood pressure cuff, and you're gonna make a flyer. before you come, and it needs to be printed. Um, so you can save your ¢10 from that other assignment that I'm at making a print and use it for your flyer, for your health, because you're gonna use these to teach people from. So, make sure you come with your flyer. Um, I'm going to divide y'all, the 10 of y'all into 2 groups, the morning group is going to go, and I don't know who's in that. It doesn't really matter. But I'm just gonna divide y'all because everybody will be doing the same thing by the end of the day. The first group will go to Buckham. We're going to be setting up our tables, and we're gonna be screening blood pressures, pulses, and as of now, just glucose, but I'm trying to get iron levels also, 'cause hemoglobin level is a great thing for people to know, especially college aged ladies. A lot of y'all are anemics. So, I'd love to be able to check that. We've been able to do cholesterol, total cholesterol in the past, but I can't get those, um, uh, what do you think, put it to the machine that, yeah, works are hard today. The little, um, you know, thank you. Yeah. It was a little bit different device, and they were too expensive, and then they phased that out. Can't do cholesterol anymore, which is a bummer. But I'm trying to get iron. So, y'all will do those checks in Valkum. Anybody who comes to the door, so it could be faculty staff, students. It could be high schoolers that are touring MHB, and they see all in your purple scrubs, and they get so excited because they're like, I want to be a nurse when I grow up. So if they want to come to our tables, that is awesome. Let's do their blood pressure in their pulses. Please do not poke. Anybody who's under 18 unless their parents is there to consent to that. This has been a problem in the past. This is not gonna be a problem with this semester. Everybody's gonna do the thing that you're supposed to. So, please, y'all do not, they cannot consent for themselves... So, just don't do their glucosis, but you can do everything else. No, you're fired. to teach people. So, somebody comes and they've got a blood pressure of... 180 over 98. Is that a good blood pressure? Not even sun pressure. So, on your handy little flyer that you made, you can show the person where they are stage 3 slash 4, hypertensive. And then you can do some teaching. You can ask them, you know, when did, have you slept today? Um, did you just down a bang? Did you smoke a cigarette? Did you maybe don't ask them and knows what? We're gonna practice their due to communication, and, um, figure out, have you been diagnosed with blood pressure before? Are you supposed to take medications for so many questions, y'all? And so we'll figure out why this person is super hypertensive and do some teaching. And then we'll do some referring after that. I don't want to just be like, dude, you gotta get control of that blood pressure. See, yeah. We need to follow up on people. We need to tell them where their resources are. So... That's what you're gonna be doing while you're in Boston. If you are not scheduled to do welcome first, then, and I will let y'all know that day of, you don't need to worry about that until you come to group health. You're going to be working on an open stacks, nutrition for nurses, assignment, and we'll get into that. once you hit crew health. I don't want to bombard you all with this stuff right now. Um, the only thing you're gonna need, I go to prepare for that clinical, is come on time and your scrubs and bring your flyer. Everything else we'll talk about in for help. But you're gonna just use open stacks to, um, do some modules, and I'm gonna assign you that module. Just making me disease. Uh, the day of... Where is it? There it is. I'll assign you in pairs to one of these, and you're gonna look and see, how does nutrition affect somebody's brain wellness? How does somebody's nutrition affect any of these wellnesses? Um, so that will help you when you are in the acute care center, and you see somebody who is, um, maybe on dialysis, you're gonna be able to encourage them with their nutrition, what they should be doing, um, or what they should not be doing with. They should be avoiding. So that's the purpose of doing that. And you will read your open stacks information. You're gonna use a whiteboard, um, and then just give us an outline, and then you're gonna, um, at the end, at post-conference time, which is this time right here. We gonna all come back together all to notice again in the classroom, and you're gonna teach each other what you learned in your open steps. Um, and that's her help. in a nutshell. Everybody has for health. No. Everybody has a CH. Did you tell me about it? Did you tell me you don't have CH? And it's on here? Yes. Okay. So, we find out the date of what time we're going for a week. For a group house? Everybody comes at nine, and everybody leaves at three. Yeah. Well, all meet, your whole group will come together at times. In the classroom that I will put on this briefing when I find out, yes, ma'am. Oh, I just wanted to ask, like, are, do you care, or are, are those gonna be showing up as placements on our X app page? something about that. It's already kind of all about these plants and food. okay. Do you? I encourage you, since we wrap up here, we can eat, can I make food? I can do that. Um, to go up to 3rd board and chocolate, you know. Is it is it this way for everybody? We're still real. It's stressing me. You could do it, my doctor's surprise. Okay, anybody else? I'm sure she does. Okay. Continue on here. We talked to opera project. We're talking about... football.. poverty... Yeah. Okay. Um, Poverty Sim stuff, that'll, that'll come later. We'll talk about that later. I didn't posted. lunch about that, if anything. You'll all... be together for that one. Um, and you'll actually get to interact with students from other schools, too. So I'll think social work, and maybe... maybe pre PT? Maybe I have some. Uh, or maybe just PT. Anyway, there's gonna be a group of other students joining us for that too. So that's kind of fun because you get to talk with other people, and you'll be in a family group together with other people. So that information will come. I didn't just want to overload y'all with more information. All right, we were trying to work our way through. The modules. Okay, so you got two online days, and then we're back in class, um, for a water activity. This activity, we're gonna be paired up again with the AB1/S1s, and y'all are gonna be in a big family unit, and you're going to experience what it's like when you cannot use, or do not have access to, um, water in a faucet. You're going to see what it's like, how many gallons of water do you think you consume in eggs? Whether it's drinking it, or washing your hair in it, or doing dishes, or, um... preparing your food. So we're gonna talk about how much water we use here in the States, and what that might look like, and not the United States. Um, and you're gonna wear clothes that you don't mind getting wet. dirty, and maybe a little sweaty. See if it's still 106 by November 2nd. Please, Lord, no, please, Lord. Um, and... let's see, let's just look at that. So this is gonna be, um, some of the information here. Let's see. What is down here? Can you open that for me? Oh, this is... Okay. You don't need a look at that now. We'll talk about this PowerPoint stuff, and we're all together, so don't, you don't need to worry about that right now. This is just some supplemental information. There's not a whole lot of prep for, um, post work for this one. is more just experiential, and, um, seeing what it's like to have to go get your water that you're gonna need. So, we will talk about how much water family uses, and then you're gonna go get that. You're gonna use bucket, and pictures, and puffs, and whatever you can use or find, and you're gonna go get your water, and then you're gonna bring it back here, and we're gonna measure it, and see if you got all your water for the day, and who won? And then we're gonna talk about some of the implications of that, and then that's the experience for that day. More info to come on that one, but that one should just be out of the classroom, out in the wild, fun to do. Um, online in class. Oh, this one right here will have a guest speaker for that one. And then your final, which... I don't anticipate y'all needing to come into class that day. So I will, um, I'll make sure on that one, because we have to have so many class days in online days. So even if it's just like, hey, glad you're here, have a breakfast taco, and good luck on finals. I'll see, because I do need to follow the rules, but I also don't want y'all to have to do things that you don't have to do. Um... Okay. Are we good, y'all? Sort of. Okay. Sorry about this. I'll get things worked out, and I'll get the corrected information posted as soon as possible. Please email me with your questions. I'm glad else of yours will always work, 'cause I'm embarrassing. All right, y'all. Let's get back here. Yeah, that was great. Please email me questions, problems. Everybody, please submit your DISD. No, no, no. She said 350? That why I was like, Oh, I gotta leave you. We did. We wrote that movie. Yeah. Yeah. You're no healthy. You know, we're kind of up in the air... I'm gonna... I'm gonna ask her about her. Bill. Did you ask her right now? Sorry, I think... A friend of mine? Oh, you were asking, why didn't I get back in my car? Did you ever go to Harford? Did I always try? No. Victoria Everson. She was... my best, I kept on my novel. These are crazy. Do they have a lot of? What? Like, do they think about it? It's because I... You aren't there to, like, pay to park in a lot, and I did, but they're saying that I didn't. I don't know if maybe I did, just working the wrong one, and then right next to each other. Either way, I was like, I already paid, so what are you charging me $70 for? What? I like it. No, no, no, not just. Just, like, tall. Judge, I'm sorry. You pay for a lawyer? No, it's not like a city or anything. Yeah. I'll report... I would not trust myself in anything. Like, any. I've gone to, like, though... Okay, go to map on Thursday. From 2 to 7. What? What? Can you text on the chat so I can hear you? I've been training tomorrow Wednesday. Wednesday? Yeah. So, then, we can just go to the lab and try this on Thursday. Okay. Oh, this Thursday? 2BD. Because I may be leaving this weekend. Where are you going? Gabby, so Gabby has this thing, like, Tamboo is doing this family day thing, and she invited me and my mom... And so it's like, we want to go and support her. Yeah, for, like, being depressing all day, so we're gonna go. Be there solidarity. Let's go. But then not me. Excuse me. Let's all go. to... Are you looking for Gabi? All right, we'll find you. okay. I'll find you, and then, um... Yeah, that would be awesome. I was walking to the, like, thing, and I was saying, All right, okay. Where is that? No. Okay. Oh, bro. I love this. What else? I'm sorry. I never saw the name... You know what I'm saying? Like, right here. And I... No, I think I'm gonna do, like, one. No, no, no. Oh, gosh. Let's see. It's, like, halfway in there. This is Churchy? No. Lovely. Okay, okay. I have my eye. Um, computer charger. Are you sure? Good. No, I'm fine. I put it we were waiting on few. know some are missing from your. I know y'all just have one week together. Um, and then last week was online. Oh, no, it's okay. I'll probably go to get started. First, we'll start with introduction. I'm Christie Carlson. Yes! Carlson. I'm a family nurse practitioner, and I teach currently in the old curriculum still, pathophysiology 2. In the new curriculum, I'll see you again in your senior year when we have a dedicated PD course. So, probably, I'll tell you, I graduated from here in 2006, behind the old building, and I was an OR nurse at Scott and Wide, and... Worked on this circle, and then we got this house and the candle being, um, and then I came back in 2011 and got my, um, master's for family nurse practitioner, graduated with that in 13, worked at a lot of the family med clinics, um, we loved to, I trained up the Santa Fe, one with the family med residents, and then when we built the South Belton one, I started working there. I helped on Bakume, when Lake Road used to be in urgent care, now it's a convenient, you know, human net again. And then when we built the bone of joint, I went back with my original team. I love the commercials. Um, when I was in the OR, and so I was organic, trauma, nurse practitioner for like the past decade. And then I came back here. This is my fourth school year to teach full time. But always have been an adjunct. So always loved UMHB nursing. It really is unique that you can come to a small campus and have small class sizes, but do your clinicals and your training at a level one trauma center? I mean, that's the biggest trauma center between Dallas and Austin, so the highest acuity in our ER, in our OR, in our ICUs. So then definitely also on our med search floors. Things that other hospitals would have to send out, they'd come to Scotland Mind. Um, things where a lot of times they keep a patient, you have to somehow send them home, and give them some good home instructions, some good rehab, and handle it more on an outpatient, because our beds are full, and icy, and messaged. So the fact that you get to train at such a high level is a really exciting thing. And I think sometimes that doesn't get talked about enough. I just think it's a small little university in Podunk town. But it really is a great place to get your foundational nursing. And then the same is true for the specialty areas, for mother baby, postpartum, labor and delivery, make you, and then the children's hospital that we have. They do the acuity backwards, so level 3 is the highest security for those areas, and that's what we are as well. Really amazing things ahead with criticals. Are y'all excited? hmm. Y'all got to do a little bit last semester with going into nursing homes, but now you'll get to practice those longer days and report, and it's very exciting. So I heard some of y'all talking and it's very true the way the new curriculum is set up. And really some of how the old one was. But beyond that intro here, our semester is that on Mondays, you have patho. And that's going to talk about what's happening in the body, how a little bit reminders of how it should, but really y'all should be pulling from your A and P, right? And then really what's wrong? something's wrong, and these are the symptoms that it's creating, and then you pick up in your AG one with, what does that look like? What do we do about it? interventions and then farm medications, right? And so, yes, studying together and then testing together. Definitely makes sense. Even some of your textbooks are written that way. Have y'all opened a textbook yet, some of you? I do think that Dr. Andrews is an amazing instructor and I'm sorry that he won't have her for a little bit. She almost goes overboard in what she spoon feeds y'all, that it's easy to not delve into the text. And so don't forget to look through that. Now, I know that these patho textbooks are not an easy reading that you're going to be cover to cover all the time. But you can, you know, go through a textbook. Scan the chapter summary, hit the highlights. If it's something you don't know, read it more. Use it. It's a good resource. And it's what you'll have again next semester. so it's able to get familiar with. Any questions thus far on my A content? Oh, I guess I don't. Have y'all been working on the blueprint? That's another really nice thing that she gives you. So I will carry out her class, um, until she returns, so I'll be with y'all, and, uh, we'll do everything if she has planned, and I think it's very well laid out. There's a lot of, um, uploaded videos for y'all to watch the head in mind. Are y'all doing good with that? Keeping up with that? And then, um, some PowerPoints that we can go over together and then class activities. Are y'all feeling good with the work, the online assignments? I think there were a few questions about quizzes. Yes, no. you don't need any house questions. So some of the quizzes, um, I think their questions were about two days. Oh. She made the due dates. She just wants you to do it this semester. This is, like, self taste learning. So she made it, like, at the end of the semester. I think she made it for, like, October, November. Or so maybe I'll look in at me like you have no idea. She made a good number. Yeah, she did, like, earlier, and he was doing December that she said, Feel free to see if you do that, like, it's more up to us. than it was due. Yeah. So she made it do like late December because she needed to do date on it. But I don't know about any later ones. Yeah, no that's it. Oh, okay. Yeah. She just said that she had sent some emails coming through. I will, um, post an announcement, my contact information, too, if y'all have questions. Um, she'll definitely answer when she can. Um, so, I don't know how much she'll know she did tell me I can share, but she had a muscular cells injuries. She slipped on some ice and hit pretty hard and broke turpatella. Which is your kneecap? And they had to do a surgical repair, so that happens when you have a mexico skeletal injury. Have to decide if it's fracture, a fracture or brake is all the same thing. What matters is if it's displaced or not displaced. So if it's displaced, which means it's out of position, it has to be put back into position. Sometimes that can be done with some finger traps and some gravity, like if it's a wrist or an arm, maybe all might have experienced some of these types of injuries growing up. And then splinted or casted and held together, right and then heals up because our bones are living, our bones have blood flow. They're living. Sometimes it's way out of position that it needs internal fixation, so if you ever get to go back for surgery, you'll notice ORIF, open reduction, internal fixation. That's when surgically they're gonna open up the area, put some internal fixation. Usually hardware of some sort, plates, screws, a nail, a rod. And so that's what they did some internal fixation for her and then close her back up. Do you think you can wait there after a patella fracture? You actually can because what are your main weight bearing bones? For your lower extremities, what do we put our weight on every day? Our femur? I know, back to anatomy You all got this. What's the main bone in your lower leg? Your tibia. Fibulous supported and helps stabilize the ankle, but if your femur is solid and your tibia is solid, you can wait there. Now she can't bend. So she has to have it locked out an extension. And so you can walk with chronically straight knees or legs. You don't want something chronically in contraction, right? Because then you can't walk. You'll have a big length. So a hinge knee rice or a neomobilizer that locks it out straight, and then she'll work on range of motion. That makes it hard to drive post up pain care that makes it where she shouldn't write. It says don't operate heavy machinery. Sometimes people's 1st thought is like forklifts, but that means cars vehicles that they're having a machine here. So she can't return with us just yet hoping at at the end at the middle or the end of my B that she'll be back. Because I gotta jump back over and finish teaching. Patho two. But we'll try to keep this as consistent and good communication as we can with you all. And it sounds like y'all are doing a good job of keeping up with everything she's already got out there for you online. Yeah. Um, I felt good, because we were talking about, so there's a diabetes class on Sherpath that's due today. tonight. But every time we think I got like. Okay. So it's a sure path like I will look at that and I'll send an announcement now. Y'all haven't covered diabetes yet so it's kind of odd. That that one would be pop Yeah. Okay. Good. I definitely... That's why it wasn't it... Let me start with roll. You did tell me... There's a shirt. Iana? Baker? Hi, Vince. Audrey? Here, here. Yes. Kylie? And she recorded herself. Nat Natalia. I'm not to rewatch this. Paige? Carolyn. Faith. You know the face? Ner? Yeah, no, no, sorry. Like, I might say what was wrong. Francis. Here. Sorry. We have one guy from farts, one man, Jeremy. Julia, here. Mackenzie. Here. Caitlin, your tape... Here. Ella. G.. Anastasia. Alyssa? Here. Kaitlyn here? Crystal? Riley. Riley, get Fresh, uh, Roe. Yeah. Sorry. You're good. Zachary. Great. Zach. Exactly. Oh, Laura... I know... Natalie, here. Annabella. Here. Alyssa, here. Brianna. Dear. Mia. Mia. Here. Allie, you're... Peyton, here's my first one. There's two pages. Okay. Okay, waterme? Yeah. Okay. Oh. And then Yarborough. She did it before science. Hey, where? She's happy. Chloe? And Mallory. Wait, what did you put? was the first one here. Class starts at nine. Just that one, say... No, no, that. I'm not getting onto you. That is a, that's a big change for me and Dr. Andrews. Um, I even text her at, like, 8:05, and she's like, I forgot classes and starts till nine. I was like why is she saying that? Did she tell you all the comedies? Y'all are very aware, so it's just like. Okay. We will get into the I'm tired. I could not wake up... I just forgot to see it. Oh, so... I forgot to... Oh. Oh, that's really interesting. Yeah. Okay, ask your process. What do y'all know? Anybody familiar? Oh, everyone has a grandma that fell and broke her hip or broke her and fell. Do y'all know what osteoprosis is? Yes, bone, brittleness, softening of bone. And so, osteoporosis is, um... categorized by a lot of ways, but mostly, um, we see that brill bone. And so, honestly, a textbook definition of osteoporosis is if they fracture with a ground level fall. So a ball from high or a car wreck, you know, those are high energy traumas, and that's normal, any age, any strength bone, would suffer a fracture. But if you fall, like, blisterfully walk and fall, like, we might be embarrassed. Maybe twist an ankle if it rolls on the curb, an inversion, or eversion injury. But if we fall and break a bone, the worry is that that bone is brittle or frill. And so it's also called a fragility fracture. Um, there's a lot of things that we can do to try to check, um, our bone density. And so they'll do bone density scans or dexus scans. So we learn, what are the common elements of people and waterways that we can be proactive and have preventative care? So right? Just like we do, um, mammograms for breast cancer, we do bone density scans to check for brittle bone disease and so. Usually that happens around 50s or 60s. A lot of it's depending on health history, if they've got significant people in their family that suffered. For brutal bone disease, then we'll start doing Dexage fans early. It's like a scanner. It's not an x-ray per se, but it does take pictures of. Shoulders, hips, knees, and kind of reads how dense. You know, a lot of imaging is shadow reading. And so it kind of can see how dense they are and then follows it over time. So on a on a Dexus scanner. yes ma'am. You guys always do major Easters can get a free Texas scam. Yes. You can. And it is it is ideal to scan on the same machine. Because some machines can be calibrated a little bit different. Not a big deal if you move from California, now you're scanned at in Temple, Texas, or built in Texas, that's fine. But to really track, it's ideal, just like if you're really checking accurate weights, it's ideal to be on the same skill. But yes, you can get a free bone density scan with our health sciences. The machine is it in Hardy or it's actually in the gym? I thought that's what I thought. It's in Maymore on that hallway with all of our sportsmen. Have any of you all done that? Pretty cool. So do you know what ages we maximize our bone density? Yes, 20s and 30s we maximize our bone density. So that's when you should be doing weight bearing activity, walking, pounding is good, running, lifting weights. Uh, the nice thing is, most women are childbearing in 2020, so they are adding some weight bearing activity, whether they wanted to or not. But yes, what are some other things that help with our bone mineral density? Like intake wise, calcium. Yes, calcium and then vitamin D D3 helps our body absorb calcium. So it's very healthy to take a supplement of D3 daily. We recommend anywhere from 2000 to 5000 units. Sounds like a lot, but it's a really small jug capital like the size of a BB. And then at least 600 milligrams of calcium daily. Or mindful of fairy in your diet. Good morning. So, bone modeling refers to the formation of the skeleton, which ceases around 18 to 20 years of age. So, during all of that time that you're forming from, um, interhedrine, extra uterine, childhood growth and development, those bones are solidifying. So little kids also it's kind of rare for them to have fractures like really young toddlers. Because their bones are more moldable still. And then we see more of high energy type issues, maybe fall off a bicycle and have a little buckle fracture on their wrist. Not a lot of things that need internal stabilization. Usually casting. And so that's why posture is important. Sometimes as kids have those big heavy backpacks, and so we really need to be mindful as we're growing to keep. Keep that skeletal formation good. Once the growth is complete and they reach adult size, then bone remodeling is responsible for skeletal maintenance. So our bones are living, and there's calcium, calcium reabsorption, and blood flow, and things that constantly are regenerating. And so that's why your bones can heal. Whenever you do have a fracture, it's kind of whisk back in, kind of like cotton candy before it gets solid again, and normal to take anywhere from six to eight weeks for a healthy individual. And if they've got some co morbidities, like some athrosclerosis or diabetes, it could take longer. For them killing kids, it happens in 4 to 6 weeks usually really quick. But that's why also on x-rays of kids, you'll see growth flakes because their bones have it completely solidified. So if you're new to looking at x-rays, you'd be like why does that kid have a break at the end of every bone? At the top of the bottom of the tibia and the femur and the humerus. Radius, it's their growth plates. The fusion hasn't completed yet. But once that bony, once they reach adult adept bone formation, kind of balances out and then we have this osteo class and osteoblast activity. That continues to happen. And then that's when we were we if we're not staying active, if we're not getting good intake for phone density. For osteoporosis, osteopenia is kind of like the yellow before the red. Like the warning that your bones are getting weaker or losing some density before true osteoporosis, which is in the red zone. Typically white females are the ones that are most prone to osteoporosis. Hormones definitely play a part in formation, so our thyroid and our perinthyroid. Y'all remember where that is? And, like, a butterfly shape in your neck there, and that helps release the calcium and the parathyroid to stimulate that osteoclass activity. And that bone reabsorption and keeps that balance of the calcium. There's kind of like a signal loop there that the blood and our gut with our absorption, our thyroid with our hormones, all of that helps keep our body in balance. And so that's what nurses are great about is understanding that the body works as a whole. Sometimes as we're learning, we talk about one system at a time, but no one system is independent, right? Like parts of the body, nothing is is uniquely on an island. And so if our gut absorption isn't working well, if our thyroid isn't working well, our parathyroid isn't working well, our bones are gonna struggle. And so osteoporosis is that weak bone or that forest bone and that increased density, which increases our fractured chances. The internal structure of the bone becomes thin, porous, disorganized, reducing the strength and making it even more fragile. So then the other thing we have to work on is balance right if they have fragile bones, then we need to make sure they don't fall. And so removing air or little throw rugs or trip hazards, making sure they don't have little small dogs at home things that would. Make them fall so age definitely plays a risk factor, gender. Both men and women are affected, but like I said, tends to be higher in women. Hormonal effects. And so definitely if they have any type of thyroid disorder, which can happen at a young age in your 20s, 30s and 40s. But also postmenopausal hormone deficiencies can also affect it. And like I said, we tend to see Caucasian or white females a little bit more, but nobody is completely. Out of the category of risk, so we screen everyone with the Dexa scan. Definitely talk about family history, nutrition, and things that wear at bone density. So smoking cessation is something we've all known, right? We've preached that a lot in the healthcare industry. Nurses are really good about helping patients understand why. So it's nicotine. the gums, the patches, the vapes, anything with nicotine is a vasal constrictor, and we don't get good blood flow. If we don't get good blood flow, then that living bone can't keep its density and so sometimes helping them understand why. So when I worked with fracture management, I'd be like, if you could just stop for, like, 6 weeks while your bone tries to heal, and if they're a laborer and they need to walk, and they need that bone heel, they're like okay. Like this affects my financial budget. And then I'm like, and now that we're at six weeks, like you've been through the hard part, like let's really stop. And sometimes you can win them over, but mostly helping them understand why. So that primary osteoporosis occurs when that that rate of bone reabsorption exceeds the rate of formation. So when we're losing density more than we're helping our bones. With vitamin D, calcium, weight hearing exercises. And so. Cellular explanations of breakdown of those osteoclass osteoblasts. And then definitely prevention strategies. So screenings, adequate intake, calcium, vitamin D, D3, and a lot of times we're learning now. D3 should be with K2, which they'll probably talk about this a little bit and farm. And then magnesium, weight bearing exercises, balancing exercises, avoidance of alcohol, tobacco. And we go coid, so steroid shots, you know, sometimes people are like, oh, I've got a bad, poison ivy rash, or oh, my sinuses, and my allergies are killing me, and they just went that quick. Urgent care, primary care, steroid shop, but repetitive steroid use can wear a bow density as well. Um, host menopausal, osteoporosis, is more with the hormonal deficiency, and, like I said, we'll see this in that parry or post menopausal. Age where they have a result of estrogen deficiency. Or if they're still struggling with thyroid dysregulation. This day and age, we we're pretty good about checking those thyroid flags and we can get that regulated with medication. But sometimes is it access to care and they haven't had their labs checked? Is it cost of medications and they haven't been consistent with their therapy? Estrogen deficiency levels drop sharply after menopause I'm into that osteoclass activity increase. Is in the bone reabsorption accelerate. It comes thin and increased fracture risk. Age related hyperparenthyroidism, independent of estrogen, where the calcium absorption from the gut decreases. Vitamin D activation declines. That serum calcium declines, and those, uh, perinthyroid plants respond by increasing that parathyroid hormone, which increases osteoclass, um, increased bone reabsorption, and so kind of wears away at the bone density. And then decreased activity decrease stimulation, bones like to be used. So stand and jog in place, do some weights, bones like to know that they need to be used. If you don't use it, you lose it. And that goes with joint mobility and bone density. Secondary osteoporosis is bone loss caused by a specific underlying medical condition. So definitely can have an endocrine dysfunction. Or any of the thyroid. Issues, growth, hormone, deficiency, lots of different reasons that it's secondary to primary diagnosis. Clinical manifestations, pain, and bone deformity because it fracture, but become brittle weak, collapse, or mis misshapen, fractures occur. More easily, you'll even see that typhosis or that hunchback. Sometimes lordosis, but usually when we see a woman with lordosis, she's pregnant, and she's modifying her stance to help with the weight. Usually with the brittle bone, we'll see that typhosis. Common fractures include femur, so that's your hip. Sometimes people think the hips are bone, but we know the femur's the bone, right? And it has a ball in socket. The hips the joint. So it's not really your hip bone. your pelvis or your femur that makes up that hip. So that's when they say carbon fractures, include a summer, distal radius, wrists, ribs, vertebrae, with compression type issues. So they'll diagnose usually with the Dexa or with, like I said, low energy traumas causing fractures. Am I going too fast? Is this all stuff you're already prepared? Okay. So, disorders of joints would be our next big concept. So non-inflammatory joint disease would be osteoarthritis, inflammatory joint disease would be rheumatoid arthritis. Sometimes you'll see that abbreviated as RA. Sometimes things are just under the umbrella of arthritis and we don't necessarily yet know on that patient the cause, but they're having some. Joint pain, sometimes joint immobility that causes the arthritis. So, osteoarchritis, previously categorized as non-inflammatory joint disease, however, inflammation is also being seen there. But it's a type of degenerative arthritis. So structural arthritis is where mechanical failure, physical wear and breakdown are the primary factors. So you'll see that a lot in these and hips where there used to be a big healthy spacing for that joint. There was a lot of senovial fluid. There's a good meniscus, there's a lot of things that are giving kind of like shock absorbers to those joints. Well, they wear down through time, we lose joint fluid. Most people if you did MRI on their knee after age 60, the meniscus is gone, and they really end up getting hex rays that look like bone on bone or just no joint spacing. That causes arthritis. It's painful for them whenever they're doing impact of walking. Moving, bending that would be osteoarthritis. So local areas of loss. Anyone that works with their hands a lot, sometimes they'll have it in their in their finger joints or in their hands. And it might even look kind of deformed in that they don't maintain that full extension. The local areas of loss and damage of articulating cartilage, inflammation, new bone formation. If there's lots of micro trauma, then that bone is like, oh, am I supposed to be healing? And so syize there's even some overgrowth that we'll see there. That happens in the joint, so. Can happen in the spine as well. When you can see it there and stiff backs and losing that pretty little S curve that they should have. Definitely genetics plays a factor definitely overuse or disused. We can see it in male females, tends to be a little bit higher in females than a little bit higher as they age. Obesity can play a factor, excessive stress. And so anything you know, high, high activity, long-standing, ride sports. It's not a reason to avoid sports. But it's just something that once in a while will notice maybe a picture will have some overgrowth in his elbow eventually. And then some, sometimes if there's a pre-sisting, a joint disease, gout, or RA, we can say that over growth. So prevention strategies, good body mechanics, labor saving devices, maintaining ideal body weight. That's something that's another thing you'll see in healthcare and that's hard that's hard as nurses to talk about. Can be a sensitive subject. Um, nobody says obesity is a beauty issue. There are beautiful people of all sizes. It is truly a health issue and it's hard on your joints and it's hard on your organs and it's hard on your skeletal. And that's a true conversation that needs to be had with patients. And too many times it's just easier to avoid it. But honestly, that is the root of a lot of issues. Um, so participating in a moderate exercise program, um, in activity, in excessive exercise can lead to premature degeneration. So it needs to be moderate. Stop smoking, to reduce the cartilage loss, and then trying to avoid or limit repetitive strain. So since I was, you can even see this, like, with tennis elbow, or if they're a fried cook, like anything repetitive, we'll see it in the wrist or the elbow. And so they do make races that can help with that or. Just compression bands that can kind of trigger that muscle to work a little more than the turning of the bony joint. So, normal joint structure, like I said, has a good synovial fluid and articular capsule, and then as that gets worn down, you'll see. That spacing will get reduced and we'll see that bone on them. So the pathogenesis of that is an abnormal mechanical stress or an injury. Um, and those uh, conjure sites, the cells in the cartilage produce collagen become activated. and release inflammatory. So an inflammatory process is part of the healing. But when parts of our body get stuck in this chronic inflammation, it can cause damage. Cartilage loss loses its smooth, elastic resilient, and that exposes stress to the underlying. And the bone response by becoming sclerotic, thicker, denser, causing micro fractures and development of cysts or overgrowth, and that puts more pressure in the joints. So the body tries to increase that joint stability by growing new bone at the margins, and so a lot of times we'll see, like I said, that overgrowth through those spurs. So you can see this in lots of different areas, spine, joints. Some more pictures. Put a lot of pictures here. Um, so this, a lot of times, is why we'll also hear about patients getting joint injections. So, steroids, typically, first line treatment, 'cause it's an anti inflammatory. But they can do different types of trying to mimic the synovial fluid. There's like different advancements in joint injections. And sometimes that can stave off a joint replacement for a little while. And so pain, stiffness, uh, swelling, tenderness, uh, limited range of motion, and then, ultimately, muscle wasting 'cause they're not using the extremity to its full. So, of course, history and physical, x-rays, advanced imaging, sometimes usually this is more for soft tissue, so usually x-rays are all we need. To diagnose bone on bone or arthritis. still with me. Okay. Is it annoying that I'm reading this through this? Okay. Rheumatoid arthritis. So, I feel like sometimes when professors pre-post so much stuff, you're like, I can do this in my room, but do you ever really dedicate the time to do this in your room? So I feel like class is like the time to talk about it. So implement implementory joint disease, which is arthritis, characterized by inflammatory damage or destruction in that cenobial membrane. It can be infectious or non infectious, and so sometimes we'll see this with diabetics or people that have comorbidities in a low threshold for their body to fight things off that their joints get gouty flare ups or. Arthritic flare ups. And so, RA, zoriatic arthritis, anchylosyn spondolitis, all of those, um, can be under that umbrella. It can be infectious or non infectious, but you'll usually see swelling, enlargement, and redness. Do y'all know what lab do you check for inflammatory markers? ESR, CRP? Yes. Yeah, those are exactly it. So a said, a said rate, or an ESR, and then the C reactive protein. Um, can be seen in, like, a CVC also, um, but usually those are dedicated inflammatory markers that we would order to check. Of course, a physical exam as well. But it's a chronic systemic inflammation that is causing that those joints to be swollen, tender, and just damaging the cenobial. And so it kind of snowballs. It's painful. They don't move it. It gets stiffer because it's not being used and so a lot of times they're also trying to break down exactly where this is happening. T cell, hyperactivation, long-term exposure to the antigen or, I mean, blobulins, and then the body is just kind of attacking itself from there. Joints most effective with RA are usually fingers. Sometimes feet, wrist, elbows, and golden knees. But usually, the bigger ones aren't as affected with RA. So hereditary and gender can play a factor, but typically we've seen it's more environmental or copo abilities. So, um, they can do some genetic testing to find some markers. Definitely increases with age. You still see this in in women more than men, so sometimes you think little old ladies that have been crocheting or doing a lot with their fingers. Environmental factors, occasionally, geographical area, maybe if we're worried about, um, something deficient in their diet, but typically it tends to be, uh, more co morbidities that we see, smoking and diabetes. So not one single cause, usually from a lot of factors that lead into that susceptibility, environmental triggers, and that, I mean, system is speculation that causes the inflammation. It's not typically something that is reversible. Um, it's usually treatable. We can help with the symptoms, so it's hard to undo the damage. So, anti-inflammatories, steroids can be a treatment. Then we worry about them density, right? So a lot of times we're trying more topical analogies, so they'll do moloxicam, mo bit. Different things. Icy hot been gay you know more of just helping kind of bandage the symptoms. Once in a while, if it's really painful, they'll do joint injection. I feel like it's still usually seeing unilaterally more, symmetric joint swelling. Yeah, they could have it both, but not abnormal to have just one hand that has a worst case of RA. Um, flexion contractures. A lot of it is just a visible deformity. Occasionally, if they've got things that are extra articular, so interarticulate is inside the joint. Then you'll see sometimes that redness can worsen and go outside of the joint. A fever, malaise, rash, our limp system, right? Because it's trying to cycle through this chronic inflammation. Reynods, phenomenon. Have you ever heard of that? They have some chronic issues and ultimately leads to poor profusion and chronically cold hands. A lot of that can come stem from that chronic joint. Issues so diagnosis relies on clinical evaluation and lab testing for sure. They can do x-rays, but usually you can already see the deformity. Did you have question? Tissue integrity. I know there's definitely some good test questions on tissue integrity. Wound healing. You'll probably talked about wounds a little bit when last semester when y'all went to clinicals. So nurses, a big thing that we need to make sure is there's not skin breakdown, right? Positioning patio, padding, and boning prominences. But also postoperatively or post dramatically, being mindful of wind healing, and so the inflammatory response is a proper thing that should happen and then calm back down. Types of wound tilling, your generation, right if the damage is minor with no complications, complete healing and function will happen. That tissue repair refers to the replacement of the destroyed tissue. A lot of times initially, we'll see injury, then we see the healing, we see the scabbing, and then eventually the scar tissue. The best thing to do to help prevent deep scarring is massaging the area. And so there's lots of different things on the market nowadays with vitamin E and Maderma. And even a plastic surgeon, I'll tell you there's probably not too much magic in the cream. It's the it's the function of actually massaging the area. And getting some good blood flow to where that damaged tissue was was working on healing. So primary intention, this type of wound involves minimal loss and close approximation of the wound edges. So if something is well approximated, it's brought back together well. Sometimes it's hard to bring something because there's some distortion of the normal anatomy, and so getting those edges well approximated isn't practical. And then once, uh, we see after that, humustasis and that, uh, clotting and scabbing happens. We'll still see swelling. 1st swelling to come and go for weeks, depending on the level of skin damage. And then that new tissue growth and that granulation tissue, so collagen formation, growth of granulation tissue with angiogenesis, epithelial cells, all of that helps with the healing process. I know there's a lot of test questions on what happens if this process doesn't work well and then what do we see? We shouldn't say a lot, but a few, um, so. This is normal phases that we should see, and then if we have trouble with, uh, wound healing or getting good blood flow to the side of the wound healing, then we'll see a disruption in the normal process. So ischemic tissue, infection, excessive bleeding, where. Or if they have a bleeding disorder, if we're not getting good wound healing. Definitely diabetes can play a huge factor in wound healing. Really anywhere on the body, but we see it a lot with lower dependent areas where they have more profusion. It's just hard to get good blood flow. And so sometimes abnormal healing or even abnormal scarring. So, wound dehissens is when those, initially, those edges were well approximated and brought back together with steering strips or sutures or staples or. Butterfly bandages. And then something caused it to dehiss or open back up. And so we worry when that wind pulls apart at that line. Usually about 5 to 12 days after stuturing. It really could happen any time, but that's when that collagen synthesis is added. Peak, and so usually that's a sign that there's an infection, um, some sort of stress on the, on the tissue there, um, or just pour healing, like I said, we can see with diabetics. Evisceration involves protrusion of the internal. So not only is the approximation no longer there, it's not well approximated, but some of the inside is actually trying to be pushed out and so. That's a little more rare, usually dehistence is what we'll see initially, but miseration is pretty severe. And so those are the two main issues that would happen with normal wound healing going off track. That's it That's the end. Okay. So, I feel like that's a lot, and not near everything, but the main things, right, about musculoskeletal, um, and skin. The main things for testing and purposes. She does have a worksheet for y'all to do today in class together, but we can take, like, a 10 minute, 10, 15 minute break and then we can work on that. Any questions about what we covered? Have y'all start? I know, I asked, at the beginning, have y'all started filling out the blueprints? Mm hmm. Okay. Feeling like you're making your way through? Some of you, not yet? Okay. Test is next Monday. Oh, my God. Are you ready? You don't have any other tests in between now and then. But after Monday, then Tuesday. And then farm is Tuesday also. We have two cents this week and we start on the bulls. Oh, make it easy? Not a lot. So you're gonna learn that you should start the blueprint after every leap. Especially 'cause she breaks it down for you. So, every week, I would go home and be like, Can I answer these questions? And not what happened, like, to look up in me. I think right now, it says that the test will be in, um, 105. I don't know if that's true, and I think probably at least smarter for us to just plan to be in here. Um, Dr. Hackney is gonna help me proctor, so I'll be around, um, and she'll be in here, but I I will put out an announcement with, like, uh, what, the test name to download for your exam soft and stuff. But I think it'll probably be... Dr. Andrews said that she was in a release like a practice exam. Do you know if she's still able to? Okay. I'll ask her. How could she do a practice signal? On exams off? Or she was just gonna have some questions. Mm hmm. Okay. Yes. I'll ask her, or I can help work on it. Yeah. I can say Yeah, it's 945. We stay at ten. We'll be back in and what about the activ? Okay. So that we did the activity... Are you okay? And check? Yeah. I'm hearing again. I'll see you soon. No, no. I have to, like, highlight it. It's just, like, not sleepy.. Me, too. Okay. It's, like, smaller... Okay. Do you want to? No, just, like, I have some. Oh, okay. I see what you're saying. Messi, but for the slideshow. How do you feel? We need other students. Oh, yeah. Okay, that's good. Yeah, it's just... Oh, she texted me. How much is this dog? She said two words. Okay, perfect. She's like, okay, I... Okay, so... Okay. Yeah. Kazi, did you want to go, just sit down, aren't they? Oh, we're gonna go to the bathroom. Yeah, when is the 12th? Yeah, I'm ready. Miss Dodds is gonna, um, be there? I think I sent a liquor chat, right? Mm mm. Oh. Not what I did. Is that your? I don't know. I need to buy some of those. Where'd you get them? These? No, no, no, the index part. That has some, but that's a smaller version. Well, they have one even bigger. They have some that are... Yeah, no, I think these are fine. Five by eight. I like how you go. It's so cute. But it was... I need to buy some. Where'd you get them? Walmart. Okay. Because I don't I like the concept marks that I have. And I like that I'm able to, like, okay, make sure, like, do the tape thing. I just want... I need a rent... need a card. Yeah, that's what I'm saying. Right. I feel like I don't know. Wait, I'll probably go and watch the lecture video. Yeah. Watch the lecture video. I'm gonna get food. Yeah, I guess we can. Well, we could get food and then do lectures. That's true. Did you bring food? Okay, yes, I'm not. I mean, I'm like... But, yeah, we can do that. Go get food. 10:30. And it puts all together here, like, nothing. Yeah, let's see. You'll get it. You might get out, probably. Chicken sandwiches. Right. I think really did it, really. Yeah, she's a replacement. So... He's not working a day. It all brings out the medication, the power.' do. Huh? I know. You're still just political. Thank you, though. In class, right?. I just got a norm. Oh, you did? Instead of coming on Tuesdays, then I said I was coming out today, and then I went back to... Okay. Tomorrow. Yay. yeah. Wait, no, but... I read that. Yeah. That's not an Adam. Okay. But it kind? No, it's not even like that. Dude, my back is killing me. Yesterday, when you left, I was in the study room, so... didn't know. I didn't know someone else was in the study rooms. and I was just laying on the floor, just looking at the ceiling, and they walked in there, like, Are you okay? I was like, Yeah, my back just really hurts from being hunched over. Tomorrow was hurting yesterday, too, and I was like, Why is there? I kept on, like, every, like, hour, I would get back on the floor and pop my baggage. I was like, am I stirting or dirty? Have you heard the controversy about that? What about Roadhouse? Like, you got a person? I sent them. Apparently, there's, like... Yeah. Yeah, we... It's stupid for class, like... Yes, she probably... Oh, there's, like, a... She was terribly here. I know, I'm like, whatever. I mean, it's not... Well, Nathan had told me, would you have to? No, I haven't... Oh... Wait, how are you? It's not bad. But, like, in... I would never try to see... You brought a word now. Okay, what? Like, if somebody would return the food more than twice? Yeah. No, they would... I'm like, do you need help? I have... We were just... We were at work on Saturday. This is so stupid. I knew, like, I was just... Oh, you do, she's making so extra. She wasn't... She was actually... She was answering my questions, like, back... Exactly. I had $40 to complain. Oh. I didn't know that. Gee, she was in full class. He was taking an exam... It's just, like, maybe... different look. And I always have a... I don't know how. I have a... Because I got lemon ch when I do. I know. I guess. I know I don't know Okay, I'm gonna I never did. I don't know why. I don't know why. I like what I like, but... It was... Not, like, good grades, but I didn't have to... And then finalized... There's several... That's what I did... Yeah. Yeah. That is... Okay, yeah, I looked it over, like, 4th place. Yeah, we got... I only have an hour. So I have, like, you only have an hour, I think. I don't know, about to put in the calculator thing. I think we have really. There's no way. Have you been using that? Obviously, it's just about, like... Well, I... But I know... Is your iPad on? I couldn't. I'm being nosy. Oh, you're doing your own? You don't trust mine, okay? Oh, no, I'm doing the new one. For Ostio, for the bunk? Oh. 'Cause you haven't done these yet. I was gonna do it after, um, just thought. Well, I guess after I watched the lecture... I'm hoping if I still write it down when I review it, it'll be like, Oh, okay. I have 4.29. So, hopefully today, I'll hit the vibe. It's only five. It's four. Oh. I have new medication this morning. Okay, Maria. I'm confused. Like, so I have, like, the community clinical. But there'll be a stupidist to make sure that we can get where I am right now. Yeah. So... Because I don't know what that is... Oh. Now, when the thing is, like, I don't know, I've always, like... I'm not even feeling late. Oh, definitely. I haven't worked till 11.. Are we gonna find. No, wait, I don't know. Wait, I absolutely need a job. But I work in the front, because I need more hours. So, I get some more photos. I like photos, but... So, I had a guy there the other day, because, like, kind of... What do you look like? I don't know, I kind of blocked it into my mind. For, like, my... And... Oh, my God. Where to, um... I saw it there. I am, too. That's good. Yeah, y'all turn off her dad. She was so weird. But when you get in the case... I know me, Luis, are saying that the backup chore, like... Top tier? Acting like a recorderback. I need to post on Instagram. I haven't posted it in my name. Hello, friend. Hi, friends. I'm stressed. Dude, I... Like, we were just going over, like, all the clinical paperwork. Yeah, it's all it is. I printed everything much. Wait, where's that? It's, like, going on the clinical thing, and, like, there's, like, just, like, 10 websites. Like 10 links. And then, me and Aurora were going over our head to toe. And then, dude, I don't know how to do it. Bro, they just told us that it's different. Yeah, it is different. And I was like, bro, I already have the other one memorized. We're not asking all the symptoms. We're not. We usually do it through symptoms. And then we have to, like, assess, like, their IV thing and everything to, like, for anyone. We have to assess, like, what is this? Oh, I've heard everything. It's right there. Is that a needle? It's a take on, but, yeah. I guess I'm saying his face. Just, yeah, it's, like, tenito, yeah. It looks real to me. I left my sploops black at home. My dad got a tomato. Oh. Oh. My dad got me three new needles. I told Luis, I want to go wake up one morning and go to, I wanted to, I wanted to go this morning at Walmart. But, um... I went to bed late and I didn't want to wake up early. These are so, like, they're so, like, de-stressing. I like to throw it. I do it at my little brother, and he started crying. I was like, are you such a baby? It doesn't hurt. Oh no, I got one thrown at me and her. Are you gonna go to the thing with us? Oh, I'm sorry. To the pharmacology? Two hours? Yes, I didn't sign up. Do I have to sign up? No, I told her that I was in a great friend. Oh, yeah. What time at 12? Yeah, I'll go. I'm never gonna forget. I need to go to the hospital. I have not gone. It's not hard. I promise if it's not hard. I don't either. I need to go. I don't know where I'm going. It was very Where are you at? Six or seven? Oh. We already went too bored over there. Ooh, is this that? We're just talking about something. Yeah, I don't care about this one. I know. Where'd you get it? Uh, my boyfriend got hurt me. Dude, I literally got my school class. She been playing with this whole time, and how much can I have? She like, no. It's mine. Oh, it's long. Yeah, that's still like... They have to bring? Francis, yeah. Yeah, that's all. That's all we need to bring from one clinic. I don't think so. Well, no, that's... This is like, I'm saying this. Wait, where'd it go? I'm gonna get her printing extra on my branch. What's this? Oh, that's, like, a practice thing that we had. Wait, what? It's like a practicing, but this thing, so, like... Later? Oh, okay, okay. That's what I do with that. So what they, like, get this line. And then that's, like, a... That's nice. Like a practice document. It's really unique. Did you see this document about how to look like? 'Cause you have to put citations on there, too. What? What? What? There's, like... citations? Like, she tried something. She don't want me to pass her class. It's a five credit course. This is what I saw. What the fuck? Sit down. Wait, is this an example? Yeah. National Library. That is insane. I was like, oh... Oh, okay. How many cents was all that? See, I'm about to, like, think, lose so much. How much is it? How much stress? Is it, like, AP format? How much sense does it, then, to burn something? Like, since... To send them? Yeah. Oh. It is, yeah. I don't know why I said too. That's crazy, bro. I knew this was gonna happen to me. Like, I knew I was, like, gonna realize, like, you're actually studying too late. Sometimes it takes up. I'm the same way. I need to study every day, and I didn't. I'm terrible when I come to work. Dude, your hair looks so good. Thank you, thank you, thank you. I cut it. She wants to cut her hair. I cut it. You will? I'll let you cut it. She wants to go short drive. How short do you want to cut it? Um, like a ba ball? Oh, no. Or, like, just like a little bit sitting on top of your shoulder. Tell her about your sister. Oh, I like that. A letter cut it one time. She's like, oh, okay, okay. Oh, cut it for you. was like, okay. And it had been like down here. Okay, just kind of like right there. She's cutting? It's uneven? She's like, I'm gonna just cut a little more. I was just kind of a little more. And she's like, she's like, I actually gotta go. You can finish the rest. I was like, this. It was a huge straight. So what did you do? I had mother sister cutting. I love cutting hair. I could be a cosmetology student. And honestly, I told me, I was like, could you cut it and mess it up? I really don't care. Like, I don't I don't grow bad. Dude, I told her to cut my hair one day. It was last year. Last year, I told her to cut my hair and she cooked way too much. She cut like this much off and my hair was long. I learn my lesson. Look how healthy your hair is now. I'm kind of good, that's awesome. We did just cut it again. But kind of good. Yeah, you did. But, yeah. But yeah, I'll cut your hair. I love cutting hair. Where'd you get those? Oh, like the binders? I Okay. Dang. I'm gonna meet this... You're so organized, friends. Like, that's a flag. Bro, she freaking printed on the... I can, I know. Oh, Princess. You're so cute. She started Jack, and... Uh... Why? I thought this was new at the beginning of date today, so we've already done these. Now, I was looking through them, and y'all done really well with that. What about the 3IK study? Have y'all have any of y'all done that? So, let's work on that. We can work as groups. If there's a few of you that we've gotten, I can get you done. But. In your module A, the 3AK study, I can print it out. Do you want me to print it out? Oh. I can pull it up on here.. Y'all did it? She had us do it last week. For your live activity online? Yeah. Okay. Did y'all turn it in? I didn't see it in the great zone. No, she didn't want us to. It was like our own... Yeah, you're from on your own. Yeah. That's what she said. I was telling some of them, Our path of classes, I'm used to them being three hours, and now in the new Creek, the curriculum, they're two hours. So she said first hour, uh, slideshow, and then the activity, and I thought it was this. But we have to think of a different activity. So I guess I can ask y'all, what do you usually do? Did y'all talk about assistant devices with Mexico skeletal issues? Did y'all learn about those last semester? Yeah. So what are different assistive devices? What do you mean? To game? Right. And those are usually called Vietnamese. Oh, um... Which side, if I have a hurt right hip, which side should I put the canon? The lo. That is right. The left side. You always employ the support on the strong side. So if you put it on the right side, and their right hip is what hurts, or what's been replaced, then they're gonna go down on that right side, put on the strong side, so when they alternate with the weak, and the strong cane, or one crutch, and then their strong leg alone, and then they have that support. You should never give crutches to adults. High school boys, maybe some college if they're still athletic. Give them a walker. You can you can partial weight there or toe touch with the walker. Crutches are only for people that have really good upper body. Unless you do one crutch if they can do partial weight bearing, you can do one crutch on their strong side. Have you all used the wheelchairs? Do y'all feel pretty comfortable? You know, they have. Sometimes they just have the basic foot breasts, but sometimes they also have the attached foot rest leg rest, and there's a lever where they can go in and out, so you can move it all the way for your patient to sit down. You can move back in and it has another adjustable to come up and down. So five south is one of the units y'all will go to and that's a ton of ortho. And they're gonna be like, Chrissy Carlson taught you and you don't know how to use any of this equipment. I wish I could teach all the equipment. What about slings? Have y'all seen Arms Wings? No. So a lot of times they'll sling if there is a shoulder injury and they need partial immobility, they'll sling. You want to make sure. It's comfortable around the neck, but the main thing is that the elbow is truly in the back of the sling so many times it's like this and there's like all this fabric back here. Inside that black arm sling, or sometimes it's navy or white. There is a loop for their thumb, their thumb, and that keeps their hand from sliding out. Their thumb sits comfortably, and their elbows sits back how it should be. Knee braces. I talked about it briefly, immobilizers, and hinge knee braces. So, there's usually the nice thing about Scott and White is there's usually a race wrap around that can help, but it is good to be a nursing student who looks like they know a little bit. So, a immobilizer is this big black or gray foam piece that wraps all the way around, and it has a lactastic straps that go all the way down, and that immobilizes the knee from bending. And then, if they have a hinge knee brace, it has gears on the side. And you lock it in and out, it has buttons you push in and you slide up. And so sometimes they'll say, lock it in extension, so that would be at 0 degrees. Lock it at 90. So you think about this, 45 would be in the middle. Think about it as a degree. I think those are the big ones. Everything else would be a cast or like a Velcro wrist brace that's pretty easy. But the biggest thing is so many people put that mobility device on the weak side, and that's a huge no no needs to be on the strong side. What else are some aha moments that y'all had over your content the past couple couple weeks? This is kind of like in general thing, but I've noticed a lot of micro lights on. Yeah, which I was not expecting. A and P in my crew, I know. Sometimes nursing students are like, I just barely made it through. didn't know I didn't need to give him. No, I don't. Um, yeah, definitely, my girl with, especially with your eyes, infectious agents. So, you know, whenever we culture something, usually they'll start them on a general antibiotic, but then they'll get the sensitivity back, and it'll let them know. So just, like, whenever you did that patriot, did y'all still do that in loud? your petri dish to grow out, exactly? What you needed? Saff and Shepherd, most common infectious agents, but sometimes it's something different, as y'all learned with ETA. What else? Okay, so some of these go hand in hand. Mobility issues, um, and pain control, right? So if they have some of these, um, skeletal skeletal issues, a fracture, or deformity, and they're treated with narcotics. appropriately, but what are we gonna notice? What did y'all learn in farm that narcotics can do? Close everything down so they're gonna be constipated. They're gonna be weak. They gonna be lethargic. So, the answer isn't, let him lay in the bed. Mobility, we need to help keep them mobile. So maybe they can't put weight on one leg or one arm, but how can we keep them mobile? Keep them hydrated so that then we don't have a GI issue, right? A blockage or or worse things that can happen there. So yeah, I think sometimes that's the big thing as you're going through nursing school you're learning things individually in a class. You got to remember now you got to like put it to connect it and put it together. And that's what you'll get to do a lot more with your day in practice. This 1st semester, it's gonna be like you and your clinical group on a unit. You'll be paired up with a nurse, you'll probably focus in on one patient, and you'll find your faculty for everything. Next semester, you'll be paired up with a nurse and you'll have three to four patients. And your faculty will be, like, What do you need before? And then your senior year, your faculty won't even lead it. They'll, like, check in on you. And you'll be doing it all with your, uh, precepting nurse. And then the last semester, like you'll work nights and weekends and be like, when do I get paid for this already? That's a weird thought, but it goes to be things like that. Yes, in the advice, in the place, we start. I know, so that's what I think you are gonna have a clinical orientation. Definitely pack a lunch, put an ice pack in it. You won't be able to, like, put it in a fridge. always. I think y'all will leave the units most of the units. You'll leave for a little while and go down to the cafeteria, but what if something is happening that you don't want to leave? What if your patient gets to go to surgery or procedure? You know, so definitely I would eat something in the morning, even if it's a peanut butter folders or a cheesecake. I know it's early. And then I pack something just in case. For clinicals, if we have a patient who's like going to the OR and it's past our clinical time, can we stay and watch or we believe? You have to leave. Y'all can't stay on any of the units without faculty. Yeah. Yeah. I know, bummer. I know, I do a cool, like, OR simulation, because it's not somewhere that y'all get to see a lot of yet, but slowly we're getting a little more exposure. So like I said, MedSurge will have a lot of patients coming from to and from surgery. they're just stable. They don't have to be an icy Mickey or CCU. I feel like get to see that. Forget what other floors y'all will go to. This semester. There was a neuro floor. Yeah, okay. And eight north, yeah. Pretty similar setup. Who are y'all's clinical faculty? Okay, you know, am I saying that? Uh huh. Staikus? Yes. A. Y'all have fun with her. Miss. I know she's on five cells and I think with psych decision on oncology. Yeah. Just trying to remember who else. Cause y'all are also in the new curriculum and I'm still teaching out in the old so I'm trying to remember who's where. I'm excited for you all. I hope y'all are too. How are y'all feeling with so many classes? I have a head space park. Yeah, stupid. You don't have all the same classes? I. Are you a transfer? No ma'am, I just I know me better well enough to know that. Oh, it's too big of allowed. Yes, ma'am, so I pretty much broke up this semester. Yeah. And the two semesters. Yeah, yeah, that makes sense. Okay, y'all have Paso, Farm, AG1, community. Mm hmm. Four. Yeah. Evidence based practice. That's right, EVP and hit went online and they're just like half and half. Man, okay y'all can do this. Y'all are doing it. What was it like last semester? Okay, let me tell y'all, the old curriculum is bad. Like, I know y'all are, like, we're getting the rind of the deal, 'cause we're the new people and the new curriculum know. Like, this is us saying we've got to make this better. And this is better. They've done the old curriculum for a little while, was doing, like, across the lifespan, so there wasn't a dedicated PD or mother baby or mental health. It was just like... Together. All in, like, a healthcare delivery, one, and a healthcare delivery, too, and a path of one, a path of 2, and yeah, three hour classes. This definitely needs a better design, but it's a lot. And I think it's hard when, okay, high school, you feel like that's a long our day. And then you come to college and you take some of these intro classes where you're like. It's an hour or two here and I go play pickleball and your friends are still doing that and you're like I live in this building on Monday and Tuesday. And then you're going to learn. I live at the hospital on Thursday on Friday. I try to get my lab done or I saw somebody off came in ready for labs today. But then you just get in that rhythm and then you graduate and they're like just work three days a week. You're like, sweet, and then all your friends who are, like, still adjusting to real life, they're like, what's this 5 day a week thing? You're like, well, you were playing pickleball. I was pursuing a better degree. So it will be worth it, I promise. I will. Doesn't work. Um, well, I'm gonna tell you, what else? Uh, who started on their blueprint? How are we feeling? Oh. Oh, my God, I graduated. She's right. So long as we're in... Yeah, she cooked one more, right? So I think the good thing about it being a lot of info is how deep can you really go? Right? If 15 questions are about pain, and 20 questions are about the three eyes, and 15 are about musculoskeletal, how deep can it really be? It's really what we've talked about, and what y'all have already done, your worksheets on. Anyone wanna share? And then they're big things. Did anyone have any major aha moments? Like, these are things y'all knew. Just had them pull back out. Did you have a question or a comment? Oh, from my blueprint 'cause there's three of them for every class. I found it was a good idea to ask, like, ChatGPT to merge the 3 of them. So they're not duplicating questions, so you're studying all through classes as soon as that time. Yeah. Okay. That is a good idea. Yeah, and I noticed even on here, she still wants to talk to you about what that looks like in a person, right? What's causing it, and what does it look like? Well, and then AG1, what does it look like and what do we do? So I think some of that will bridge a little bit. Too. And the nice thing is, when you take your tests on Monday, if you're like, Oh, goodness, I was weak in this area. then you can hurry for Tuesday. Are y'all trying to work too right now? Yes. What are y'all doing? Oh, y'all can text, since y'all did clinicals. I applied for Lostbuster, and they didn't take. They didn't take you yet. Yeah, yeah, definitely next semester. It's not hard to do. Teching? You just have to do four shifts a month, so if you did Saturdays... That's my study day. I know, I know, well, I'll tell you, we used to do class from 8 to 4 Monday, Tuesday, Wednesday, and Thursday, we were at the hospital, not just, or, and then Fridays, we had labs, and then we do Saturday teching. And you could do back to back eights, as long as you moved units. So we'd do, like, a 16 month. Yeah, so then some of my classmates when they got out of nursing school, they were like I'm bored so one went to work at David's Bridal so she could get a discount for when she got married. Oh, that's so similar. photography company. I like, you're bored because we're used to working six days a week. But yeah. Wait, wait. I'm telling you, this is the time in your life to pour in the time and the energy. It will pay off, though. Okay, so what jobs are y'all doing then? If you're not checking. I'm working for my family's ranch back home, so... Okay Thank you. That's good. Carmen Ranch, anybody waiting tables? I think that's so smart. That transitions into nursing care well. Check on them, let them know you're coming around. Because if you don't check on your tables, then they need you, right? If you check on them, they don't need you. Same with your patients. Check on them, let them know you're coming around. If you don't check on him, they are on that call, like, the whole day. And you're like, If they know you're coming around, then they won't. Like, she'll be back. I don't need it. It is. I think that translates well. What are your jobs? Okay, that's good. Exposure to rest? My family owns a T shirt business, and I do all the designs for it. Okay. And then, I'm a teenager. Oh, yeah. That's really good. What? You do lab? Yeah. What day? Okay. Yeah, so... Okay, well, I'm definitely not gonna let us out this early, but I will let y'all work on your blueprint. So, let's spend, like, the next 20 minutes, so we can work quietly or consult it here. Okay, babe. I go... Yeah, I think older siblings than a waitresses definitely transition into nursing quite well. Well, that's also adult guarantee. Do you want any this one? She's not gonna be over here. She's working out... Yeah, I guess she's... For, like, the... She's No. Frances, I'm gonna work on the... lecturer... for... Professor? Matt? Yes, like, mainland or whatever. Sorry, it has like the noise cancellation. Yes, that's correct. I just happened, okay, what are my friends? The Adrian was, like, the Adrian? I did not know how that was. Really? Oh, this is too bad. I need to go try tom I always draw When they're going, like, the tower arch? The dark... I'm just... Yeah Yeah. Did you learn how to use men, great? Snow litters. They're literally doing nothing.. It's a level for out of our home. No way. They're, like, on... So, wait, you have to do it this weekend? Yeah, it's broken here. Everyone knows everything. I'm trying to... I've seen so many, like... You don't have to do it. It's only a few more chords when you graduate when you get older. Yes. I've never heard before. It's always... So you And I think, Oh, my God. Okay, thoughts. She went over today, and he had virtued all day... songs, and studio, and they go to California, of course... We found density... It's, like, drop protectors? He really... Am I late? I know that's not, like, for a person. What happens? So, I'm undergoing... I'm always going to take that, you know, talking about what the song is about.. Does that feel better? Right? I was, like, it's still... Because, like, they can heal, 'cause, like, it keeps... No, we'll just try to, It's, like, right here. Are you, like, like, like... I try, like, share it out, like... Oh, my, yeah. Because we've been trying to... I've never been out both the time, like... Okay, I do usually start off my patho to force with. We do not make fun of people for mispronouncing, because I mean, they read it. Yeah, I say things exactly how they're spelt, and it is my biggest helpful. Yeah. Silicon. phonetically. Yeah. See, sells works indeed, though. Yeah. I'm so toxic. I'll download the box. So let's go... That's a great... Thank you. I I feel like if you think too much... Definitely, okay, that sounds cool. For Morgan, are you going to use, like... Thank you. Uh... That's the crazy thing. Yeah, because they use the animals... Yeah. That's why I wanted to tell you first. I don't get it. Let me re read this. So in the thyroid, when the calcium flows, like, it increases. Calcium? It makes sense. When the park, you're a nine point is long. When the costume is low, it's really red dark. What's your name? I have a question. Okay, what's your name? Crystal. Can you hear me? All right. I have a question. Yes. Don't listen. I'm reviewing the notes, and I'm kind of getting stung right here. Mm hmm. So, is it when the calcium is low in your thyroid? Yeah. That's whenever it's doing parathyyroid, like, it's a stimulating formality. Yeah. So it's, like, a feedback loop, and then it produces. And so ideally, it keeps it bad. But if it's, if it's too much, then that's gonna increase the blood calcity. And so then it pulls it from the boat. I'm still lost. Of how the hormone works, or what? Like, what's the difference between these? Thyroid is going to be low, right? The parthyroid hormone increases the blood calcium. And the calcid tone lowers, lowers it. Okay. That makes sense. I need a review anatomy. Me, too. Mostly understanding that the thyroid and the parathyroid is like a feedback loop. And so if there's too much in the blood, and the hormones will stimulate more, or the hormones will stimulate less. And so knowing that if it's low, then it's gonna increase the serum calcium. That calcatonin is high, then it's gonna lower the syrup calcium. Okay, that makes sense. Okay. And you need calcium for good bone. Yeah. And you need vitamin D to help you absorb. Wow. That's got it. Okay. Is that good notes? I need that. I'm just, like, watching her lecture, 'cause she didn't know me. So now that I have free time, that's what I... Oh, wait. It is. It depart, if the thyroid is low, it... Increases. Are you gonna...? I'm not. Everywhere. All around. I'm just start studying today. And just, I'm gonna do one today. I probably gonna do patho. Tomorrow, I'll do pharmacology. And then Wednesday after clinical, I'll do my paperwork, and then probably do MedSurge, and then again, start back up again, Thursday, Friday, scary. Yeah, we're doing, like, a concept map. Yeah, for... But, like, when you paint out in HG, like, on your thing, it says it's recommended, you just do it together. Yeah. Because it's all good. It's just hard because it's, like, we have to know the pathophysiology of the disease, and then we have to know the signs and symptoms of it. And then it's like, okay, well, what do we do from there? But it's like, I don't know. I think more, my things, like, knowing what type of questions we're doing. That's what I'm saying. Not to. I actually did promise you when I was talking to you, but I was like, one hour. I just hope it's not hard. It's going to be, but... And the blueprint's different. Their blueprint's, like, asking us a question. And based on other, I think I'm just so used to, like, our 1st semester. The cat was sick, you know? Are you listening? Is she listening to the lecture? I'm gonna do that. Was she talking to me this whole three? Are you talking to me this whole time? No. Okay. I'm sure it's 'cause No you're listening, right? I was like, I'm gonna go do that. I need to do that. Yeah, you have to ignore... So... It's time... I, I, I, I, I, I, I, I, I, I... That's cool. And I usually have like... She knows there's any... You're my favorite, I don't... It's okay, because Chad meets you. They're gonna do great. Don't even worry about it. Really? Do you want to go there? So, could you explain this to me? If the parathyroid is low, that means... Casetonin is the... Question marks? Yes, the wording... Yes. You know what? High functioning, like... So she just.... But the only thing is life... I wasn't gonna get another one... Oh, yeah. Yeah, she's so... It's not bad. Yeah. And, like, I mean, I'm... And then, like, it's all of their... So, like, I'm very... Yeah, practice such in there. I'm reaching out to her, but here's a good, like, practice question while discussing hormonal control of bone formation. The nurse recognizes that which hormone increases blood calcium levels. Okay, which would decrease it? So it'll be... So, whenever the council is low... No, whenever they ask him, he's low... Like, when he's talking, like, he must come down. Okay, let me write that in my heart. I'm trying. Every time I go, my own is sticky nose. Okay, so, like, this is... Calcium low. podcasting. Can you stop? It's going to relieve. I, like, also, I swear. Parathar. Bring an example. Or to bring it up. Sorry. Because it's already down, but when it release... To bring calcium around. Which This is where I'm not getting this. Okay, when the house was high. So it's basically a... This is why it's slow. This is what we're gonna do to bring it up. This is why it's high, and this is what I'm doing right now. What we're gonna use for. So, like, the calcium is gonna be high, but we're gonna release this this formula to bring it down. Okay, okay. It's basically a flip flop. So whenever... So whenever they have time... We're gonna release the terrorists. It's usually like... To decrease coffee. All right. Next flight, please. So, I can... I never really do. I don't know. I might... There's a chance... No, you better hear... Yes, yes, yes, yes. She was... She was... The cookies last year, not too young. You're so... You're honestly... And they can also be very spiritual. More than that. Yeah. I need to do the lightest... She's very... There's something I want to eat. She gets... Our respection is... I don't know. That's good. No, seriously. Okay. I was worried. There's so much that can happen. Yeah. Did you write down a combo product? Like, whatever I did. No, I didn't ever since I take your trigger so often. No, no, no, no. So, this is... I need to think... I think if I thought about it, I would probably figure it out. Like, probably... Oh, my God.'s the dailyion I wouldn't test there anymore, bro, at A.P. 81. 1 milligrams? day. For daily living, right? And then it could be... It is When I hear Evan, then you want to chew ash. Yeah, yeah, yeah. Which type of have, like... Do you design your... She said... She... Uh, she's hyping my diarrhea. Did you like pizza? The bone break down? Yes, you do, Obama, and I have just... But I may have just waited on her. It's amazing, but... She's... Really? Did you get? Yeah, I read that. And both buildings. I am... She's allowed to say... Oh, my gosh, I cannot spell. Relax. Speech of bone breakdown. Yeah. Yeah. I never took. Okay, no. Just made up, I'm gonna break down, and I'm both nothing. I came in from one... I'm sure... No. Right. I went back to... I mean, there's no way... He's made it, and then... Right. She told them, I'm sorry. Yeah. So, she would... Yeah, yeah. She said something immediately, and then... Yeah. And then you're like, what's impossible?. And then, like, there's, like... And then, like, there was no way they could have started... And then, like, look at his daughter, like, I tried giving her CPR. EMTs came down and he was sitting on the couch and she was facedown. Have you seen that, like, continuing? I don't know. You know, you can do that, like... Hold on. But that... Wait, actually... The breakdown is faster. But that's why they... Oh, really? Yeah. Actually... Let me go back and check. I I think, I think, regardless of what they're... Oh, yeah. Yeah, okay. I think, so, again, the jury, is it, is it jury? Yeah. I think she's going to... Three and a half. Really? I think they're, like, more than a month ago. She... I never would help her. She asked questions that I had. She's, like... Sorry, David. It's like, it's one of those... It's just, like, down... I feel like there's enough... I think that was for thyroid or something. Did hybrid? Because, like, it speeds up the freaking thing. But because the speed, the breaking down of the bone is happening so fast that the bone, they can keep. I mean, either way, she's almost everything, so I said, situation, right? So that's why I'd be like, all right. I did it to a date. Yeah. Yeah. But if she doesn't... I think it would be, like... That's what I was trying to do. do. You know? That's happening. I think it's a really sad dream. I think it's scary. I agree, not being able to know the whole story. Yeah. Okay, y'all are certainly welcome to stay. okay. I'll be ready for Madri. Y'all got my day. We'll test next week. We're gonna be great. Y Thank you. Thank. Okay, I want to ask you grab this cigarette, some more places, but I will... Oh, good, Bo. I guess they do. You know what? Okay. All right. Are we still gonna work? Are y'all ready to eat? Yeah. Just don't wanna know. Someone did. What are we doing? Yeah, and then you're not like, yeah, okay. And so, uh, P.A.C. reminded me, whenever I know her, they had a good brother with an interaction.. Sorry, I can't do it. Worry about it. I need to... Which words are gonna do, like, scissors? And then you must, you know... Oh, sorry. Anyways... Danny... Oh, my God, your, uh, just come maybe through Etsy. Her feeling? Yeah. What? It worth it. So, um... Uh oh. No more. Because I get my stitches, and I'm not being... I need to practice that, because I take, I have my Osama. So much about their butter. So, and then, like, our population was, like, really, like, this is, there's always weird. Yeah, I know it's like I kid you not. I have noticed that, like, how you go... And I used to... Where's the PowerPoint? Yeah, I've literally just finished. The only thing is remember September 6 we have the SDOH worksheet due for that class. He started it. It's not small. It's not real... I like it. I started it. If you go September, when is it there? Sixth. So the week the week. Started on the first ones where I don't like. Yeah, the week of our exams, we do that weekend. Okay. So it's like, I want, I started it. I haven't finished it though, but it's not like... It not like writing an essay. But like Yeah, I want to make sure I understand osteoclass and osteoblast. Can you explain osteoclast and osteoblast? Like, if I were a five year old? Chat. Do you get it, like, about the bone? Like, that their cells that break down the bone? And the ones that build it back up? So it's also your class. I think that's the one that builds the bone. I think osteoblast is the one that breaks it down. I think... Osteoclast breaks bone down. Okay, I feel black. built up. So I think it says, think, class... The sea with crash, and think, blast with build. With a B. Wait, doesn't it say that somewhere else for us, you know? Or am I chirping? I haven't seen it. Let's do a blast is... glass. Okay, ready? So that means wrinkle. Is the activation of osteoclass, which is breaking down the bone. And then OPG decreases phone loss. It increases. Okay, so for here, I just need to know. Increase absorption. Okay. Also, they hold the crap out of her. Because it's two parts. part one and part two. She finished part one, like she didn't finish part two. That's what I thought. I was gonna say something. I was two, and then I was three. But I was like, if everybody knows that here, clearly we don't want her to teach it. You know what I mean? There was a part too. Yeah, cause it was osteoporasis and ruth maturity arthritis. We were supposed to go over today. She went over room to arthritis stuff. Um, but there was more slides left because. Yeah, this is the whole power. I was on mine and I was like, yeah, we went through 52 slides. Oh, are you sure? Yeah. 'Cause I, look, I copied her... a house. Oh, she did? Oh, she did? She might do that. Dude, I thought she didn't, because I was like, I gosh, she didn't do it to everything. What the flip? Oh, no. We talked about osteo porasis or whatever more than we talked about rheumatoid. Osteoparais is non-inflammatory, rheumatory arthritis, inflammatory. Just remember, I just... Itis is inflammatory. But then I'm like, what is specifically osteoporosis? Because I get the arthritis one. Osteoporosis is just basically like the breakdown of a bone. And like it getting thinner and more fragile, and it increases the likelihood of a fracture. I just remember Anis's inflammation. So, like, if it's rheumatoid arthritis, it's inflammation of the rheumatoid. Or whatever, joints. That's crazy. I don't remember itis like that. I don't know why. Like cysitis, that's inflammation of the bladder, right? See, I don't know why I can't. Okay, maybe that's how it is. Sis is state of, but I don't know how that makes sense. State of osteo, Peru. That makes no sense. Like, sis is state of. Okay. Yeah. I don't know how people are studying. I'm gonna skip this because. Okay.