Erica Glenn

12/5/12

Emergency Room 

Learning Experience Journal 
1. Assessment of the Environment

• Personnel- The majority of the ER is women. But the main doctor is a man. The personnel is all very nice and have to be good with patients and stuff. 
• Services Provided- The ER provides emergency care to patients that are ill or have just been in a car accident (trauma) or something along those lines. They draw blood and then send it to the lab to be tested. They also insert catheters into patients. They also check vital signs and help the patient in anyway they can to find out what is wrong. They preform many tasks along these lines in the ER. 
• Equipment- There are many pieces of equipment in the ER including, vials, IV's, catheters, thermometers, computers, ultrasound machines, xray screens, sinks, needles, tourniquets, and many other supplies and equipment. 
• Technology Utilized- Computers that were monitoring vital signs. Also, the main piece of technology is the machine that holds all of the medicines and stuff that the doctors need to help the patients It is like a vending machine that charges the patient for everything they use. 

2. Observation

• Health Care Professionals- When we first walked in, all of the women were sitting around talking because there were no emergencies going on at the time. But then later, when patients came in, they became rushed and running around. They all seemed nice and professional, but Monday wasn't there, and that is who Marcela and Dorian suggested we observe. 
• Teaming Skills- All of the heath care professionals seemed to work well in teams. When the pregnant woman came in, three or four doctors had to work together to help her. It was pretty crowded in the room with all of the people in there, but they were all working together, so it went smoothly.
• Communication Skills- All of the doctors know what to do and how to communicate it in an affective manner. When they were working with a patient, they spoke in a manner that they would understand, and were very nice to the patient. 
• Safety Procedures- When taking blood or touching the patient at all, everybody was wearing gloves. Also, when taking blood, when the needle was taken out, it had the cap put back on it and disposed of in the sharps container. There was also multiple trash containers for different waste disposal types. Also, the sink had to be turned on with your foot, so your contaminated hands didn't touch it. 
• Therapeutic/Diagnostic Procedures- Mi and I saw an old woman get a catheter put in, as well as a lot of blood drawn (one from IV, and another from the hand). Also, there was a pregnant patient who came in, and we saw an ultrasound, her temperature taken, and more. There was also another patient who came in and threw up, and we saw him get some meds.

3. Knowledge

• New Information Learned- I learned that when putting a catheter in, the patient should be laying as far back as possible. I also learned that there is like a portable little machine that is just like a little only sound ultrasound machine that listens to the heartbeat of the baby. I also learned that some people come into the ER for very minor things. 
• Medical Terminology- When Mi and I were in the ER, there was not a lot of medical terminology used.. But there was a few. IV= Intravenous Therapy.
• Skills Learned- I learned to stand out of the way when the nurses are running around trying to help a patient. I also learned the steps on how to put in a catheter. I also learned that if you come into the ER with abdominal pain and you throw up, you cannot drink any water. 

4. Evaluation

• Personal Experience- I enjoyed going to the ER, but i definitely do not want a career in that field. I would not be able to handle the trauma or disgusting aspects of the ER. (Vomit, etc.) 
• Educational Value- I did learn some valuable information while i was in the ER, and I enjoyed my time seeing new things and seeing the difference between a real life ER and the TV show's ER. 
• Professional Value- I got some professional value experience while i was in the ER by observing the health care professionals and such. I also know that i do not want my professional career to have anything to do with the ER. 

Learning Report

1. What were your responsibilities or duties this week?

• This week , when the pregnant woman came in with shortness of breath and chest pain, one of the doctors asked me to go get the thermometer. I left the room and was like frantically looking for the thermometer and i was like asking the person behind the desk and she said it was on the wall. I was like looking everywhere for that thermometer and i kept saying "Where is the thermometer?!?!" and finally she pointed to a wall very far away and i like ran over and got it and ran back to the room and gave it to the doctor. That was pretty much the only thing i was asked to do this week. 

2. What new knowledge or skill did you learn this week?

• I learned that in the ER, they keep a thermometer in a special place on the wall for some reason instead of one in each individual room.. I also learned the steps on how to put a catheter in. I was also talking to another older student in college and i learned how not difficult it is to become an ER nurse. 

3. What was the best thing that happened at the ER this week?

• The best thing that happened in the ER this week was the pregnant woman coming into the ER with chest pains and shortness of breath, because she was the only actual emergency we saw the whole time. 

4. What was the worst thing that happened in the ER this week?

• The worst thing that happened in the ER this week was the fact that when we first got there, it was really quiet and we had nothing to do but talk to the women, who were talking amongst themselves, so it was pretty hard to interject into the conversation. 

5. The "worst" was not really a personal mistake, so there was no way to correct it.

6. This week was fair because neither Mi or I got to do like anything, and we were just standing there not knowing what to do for a pretty long time. It was fairly awkward because the person we were observing had another college student that she was trying to teach, so we didn't get any of her attention, and she kept leaving without us. 

Experiene Record

• Technology Observed: 
• IV
• Thermometer
• Computer
• XRay machine screen
• Needles
• Catheter
• Etc.
• Diagnostic Procedures Observed
• Inserting a Catheter
• Listing to an ultrasound machine
• Temperature taken
• Nurse asking questions to see what was wrong with the patient
• Therapeutic Procedures Observed
• The catheter was inserted to help the patient, so i guess that could be considered as a therapeutic procedure.
• No other therapeutic things occurred while we were in the ER 
• Diseases/disorders Observed
• There was one patient with abdominal pains and was throwing up with stomach-bug- like symptoms
• There was another patient who came in with shortness of breath, dizziness  and chest pains. 
• Medical Terminology encountered
• IV- Intravenous Therapy
• Cultures- Bloos cultures
• There were not very many other med terms that i encountered

Experience Journal

This week i was in the ER with Mi. When we fist got to the ER section, we had a woman joking with us that it cost $2.50 to get into the ER, and we all had a little laugh. Then we both entered into the ER and walked up to the desk where there were a bunch of women sitting around, and we introduced ourselves, and someone told us to go observe Jennifer, so we found her and introduced ourselves to her. THen she went into a patients room, so we followed, and the college student girl came in with us too. Then Jennifer put a catheter into an old woman, took blood and then took some more blood. After that, Jennifer went into another patient's room where the guy had just thrown up, and she was asking him a whole bunch of questions and stuff. Then she left that room, and like had to go somewhere, so she ditched us. So Mi and I asked to observe someone else, and so we did. Then a patient came in with shortness of breath and was about to throw up and she was really dizzy and pregnant. So her whole room got very crowed full of people, and Mi and i were just trying to stay out of the way. Then one of the doctors asked me to go get the thermometer, so i was frantically searching for it, and found it and ran back to the room. The doctor was asking the girl tons of questions while the other doctors were putting all sorts of stuff on the patient. Then they did an ultrasound to listen to the babies heart beat, and everything was okay. Then it was time to go, so Mi and I left the room and thanked the pople for letting us observe. Then we left, and made our way back to the cafeteria. 

Erica Glenn

11-30-12

Day Surgery

Experience Journal

      I.         Assessment of the Environment

a.    Personnel-The majority of the personnel in the day surgery were females. Actually, all females, I didn’t see a single male. But they were all very nice people.

b.    Services Provided- Day surgery provides many outpatients care surgeries. Meaning that you check in, have your surgery, and then leave later that day.

c.     Equipment- There is not a whole lot of equipment used in day surgery.. There were a lot of beds and such. Also, there were computers and screens that monitored the vital signs of the patients after the surgery.

d.    Technology Utilized- Computers were used to look at the vital signs of the patient. Other technology was used to observe and help the patient.

    II.         Observation

a.    Health Care Professionals- All of the health care professionals in day surgery were females. But the majority of the doctors that were preforming the surgery were males. But they were all very nice, and happy to be working there.

b.    Teaming Skills- All of the people in day surgery had very good teaming skills. While I was in there, they were putting up Christmas decorations, and they were all working together to finish the project.

c.     Communication Skills- They were all good at communicating. Once, someone had misplaced something, and everyone was communication and trying to find it. So overall, they all had good communication skills. Also, when one of the  nurses was talking to a patient about all of the discharge stuff, she was very good at communicating all of the information.

d.    Safety Procedures- I only saw a few safety features while I was in day surgery. These included wearing gloves while taking the IV out of the patient. Also, when the patient was lying in bed, the rails on the side of the bed had to be kept up at all times in order to keep the patient safe.

e.    Therapeutic/Diagnostic Procedures- I did not actually observe or see any therapeutic or diagnostic procedures preformed, but I know that a few patients had gotten a colonoscopy. Also, they had been administered anesthesia during their surgery.

  III.         Knowledge

a.    New Information Learned- When I was in day surgery, I learned that when a patient is being discharged, two ladies come with a wheelchair to escort them out. That is the only thing I learned while I was in day surgery…literally.

b.    Medical Terminology-

                                              i.     CNP

                                            ii.     PRBC- Packed red blood cells

                                          iii.     EGD- Esophagogastroduodenoscopy

                                            iv.     LAVH vs. TAH- Laparoscopic Assisted Vaginal Hysterectomy

c.     Skills Learned- I learned how to take out an IV. You take off the tape, first, and then gently pull it out, and cover it with pressure and then a band aid.

  IV.         Evaluation

a.    Personal Experience- I had a pretty awful and boring time while I was in day surgery. It was extremely boring and uneventful. Literally nothing happened. It was just like chitchat time for all the ladies working there.

b.    Educational Value- I did not learn anything useful while I was in day surgery. It was extremely boring and uneventful. Literally nothing happened. It was just like chitchat time for all the ladies working there.

c.     Professional Value- I guess it could kind of be considered as being kind of professionally valuable. I saw how boring their job was. It was pretty much all paperwork and nothing cool. I definitely would not want to work in day surgery.

Learning Report

      I.         What were your responsibilities or duties this week?

a.    I literally had no responsibilities or duties at all. I did nothing the whole time. They were just talking and filling out paperwork and on the computers the whole time both days, so I literally did nothing.

    II.         What new knowledge or skill did you learn this week?

a.    I learned how to take out an IV. You take off the tape, first, and then gently pull it out, and cover it with pressure and then a band aid.

b.    That is the ONLY thing I learned at all.

  III.         What was the best thing that happened at the unpaid work-based learning site this week?

a.    The best thing that happened to me this week was on Monday, I walked in, and the nurse said there was nothing to do, so she let me sit in the chair. As apposed to me standing for an hour on Wednesday not doing anything.

  IV.         What was the worst thing that happened at the unpaid work-based learning site this week?

a.    The worst thing that happened to me this week was having to stand awkwardly by the desk for the full hour and a half on Wednesday, it would have been much more convenient if I could have sat down, but nobody asked me if I wanted to sit, so I didn’t. I had to stand there forever doing nothing.

    V.         If the “worst” was a mistake, how was it corrected?

a.    The worst was not a mistake, so there was no way for me to correct it.

  VI.         This Week was: Bad

a.    Why?- because literally NOTHING happened the whole time. There were no patients on Monday and it was the most boring thing ever.

Experience Record

      I.         Technology Observed:

a.    Computer

b.    Refridgerator

c.     Freezer

d.    Coffee machine

e.    Scanner

f.      Vital signs machine

g.     Nothing else or cool

    II.         Diagnostic Procedures Observed:

a.    Nothing

  III.         Therapeutic Procedures Observed:

a.    Water was given to a patient

  IV.         Diseases/Disorders Observed:

a.    Colonoscopy

    V.         Medical Terminology/Abbreviations Encountered

                                              i.     CNP

                                            ii.     PRBC- Packed red blood cells

                                          iii.     EGD- Esophagogastroduodenoscopy

                                            iv.     LAVH vs. TAH- Laparoscopic Assisted Vaginal Hysterectomy

Learning Experience Journal

            When I walked in on Monday, I introduced myself to the nurse, and she said there was nothing going on, and that I should take a seat. So I sat and she went back into the break room, so I was out there all alone. Then a few of the other nurses came out and they were just chatting forever, doing nothing. And I couldn’t interrupt their conversation because they were talking about their kids and stuff. So that was really boring. There was not a single patient the whole time, and nothing happened. So I left. And on Wednesday, there were more nurses, but they were all sitting at the computers charting and working doing paperwork and stuff. I stood by the desk practically the whole time doing nothing but staring at the clock. But then one of the nurses was going to discharge a patient, so she let me observe her talk to the patient, sign papers, and take the IV out. That was all I did, and it was very boring. And then it was time to leave. So I did. I did not have a good time, and I don’t really want to go back to day surgery because it was so boring.

Day Surgery Questions

Describe the purpose of a surgical consent form: so the patient consents and knows what is going on.

Describe how the patient identity is verified during the surgical experience: bracelets and name tags or something.

Describe the purpose of pulse oximetry: a pulse oximetry is something that takes your pulse.

What risk factors are associated with anesthesia: not waking up or dying, etc. 

What are the components of a patient assessment: assessing the patient

Explain how the patient’s right to dignity, privacy, and confidentiality are maintained: no information is released without patient consent

Identify the members of the intraoperative health care team: during the surgery, the people that help. 

Who is ultimately responsible for patient discharge: the nurses that are responsible for the discharge. 

Identify the criteria for patient discharge: paperwork and telling a lot of stuff to the patient to make sure they understand. 

What is the PACU: post anesthetic care unit

Identify the five most common surgical procedures performed in day surgery: colonoscopy, etc. 

What are nosocomial infections: infections that are noscomial

What infection control procedures are done to reduce the spread of infection in hospitals: washing hands, and other sanitary measures. 

Differentiate between intubation and extubation: one is in and one is out.

Erica Glenn

11/14/12

Respiratory

Experience Journal

      I.         Assessment of the Environment

a.    Personnel- On Monday, I worked with Jesus. And on Wednesday, I worked with a woman, who I believe her name was Kim. But there are always two respiratory therapists in the department, and on Monday, it was two men, and on Wednesday, it was two women.

b.    Services Provided-The respiratory therapists are in charge of all of the patients that are in the ICU. They help the patients get off of the ventilators and respiratory machines that they are on after surgery. Also, the respiratory therapists are in charge of responding to all of the code blues in the whole hospital. I also saw an ET tube on the airway of one patient.

c.     Equipment-There is a lot of equipment that is utilized in the respiratory department. Mainly, the ventilators are very important because the patients cannot breathe on their own, and need the help of machines to remain alive. Also, the monitors that show the vital signs are very important to see how the patient is doing. Also, I saw a Mac 500, AirGas machine, VMax machine, a PFT test, etc.

d.    Technology Utilized- There is a lot of technology that is used in the respiratory department. The computers and monitors that show how the patient is doing are very important. Also there are many computers and such that are used. Also, the respiratory therapists need to use the lab to to test blood and such, so there is a lot of technology utilized in the laboratory for respiratory. Also, when doing a PFT test, Kim used some sort of breathing machines to test the air of the patient. Mac 500, AirGas machine, VMax machine, a PFT test, etc.

    II.         Observation

a.    Health Care Professionals- In the respiratory department, there are a few health care professionals. On Monday, there were two males, Jesus and someone else who I did not know his name. And n Wednesday, there were two females, Kim and Pricilla. But when we went into the ICU, there were a lot of nurses, technicians, and doctors helping the patients. Also, there were two nursing students that were in the ICU observing the real nurses.

b.    Teaming Skills-The two respiratory therapists have to work well together when a code blue is called. They must work together well in order to save the patients life. They all work well in teams in order to help the patient.

c.     Communication Skills-The health care professionals that work in the respiratory department, all have to have good communication skills in order to save someone’s life. They also are really nice, and communicate well with each other to have fun during their workday.

d.    Safety Procedures-There are many safety procedures that are used in the respiratory department in order to keep all of the patients and workers safe. Mainly, when I went into an ICU room, I had to put a lot of PPE on, including a gown and gloves. Also, there is a code blue button in every room that is there for when a patient codes, the button is pushed and everybody rushes into the room in order to save their life.

e.    Therapeutic/Diagnostic Procedures-There was a few therapeutic procedures that I observed in the respiratory department. These include the ventilator that was there in order for the patient to breathe. But for a diagnostic procedure, I saw an ABG (arterial blood gas) test that was testing the amount of gasses that are in the blood in order to see if the patient was ready to be taken off of the ventilator after their surgery. I also saw another diagnostic test that was called a PFT (Pulmonary Function Test) that was for a patient to see how well they are breathing and what kind of gasses are being released during their inhalation and exhalation.

  III.         Knowledge

a.    New Information Learned- This week I learned that in the respiratory department, there are two respiratory therapists that have to respond to every single code blue in the whole hospital. Also, I learned that a PFT is a pulmonary function test, and that an AGB is an arterial blood gas test. While talking to one of the respiratory therapists, I learned that you could possibly get your employer to pay for your schooling in order to further your medical degree, which she did. Also, there was a patient in the ICU who had had an open heart surgery many years ago, and during the surgery, the doctor accidentally cut his diaphragm, and since he only had one lung, he is going to have to be on a ventilator for the rest of his life and cannot speak. I thought that that was really sad and depressing, but I still learned something new.

b.    Medical Terminology- I learned a few new medical terms this week.

                                              i.     PFT- Pulmonary function test

                                            ii.     ABG- Arterial blood gas

                                          iii.     Code- Code blue

                                            iv.     Trach- Trachicastomy

                                              v.     COPD- Chronic Obstructive Pulmonary Disease

c.     Skills Learned- I learned how easy it is to do an ABG test. I also learned how to take something out of the fancy machine that like charges the patient whenever you take something out of it.

  IV.         Evaluation

a.    Personal Experience- I had an okay time this week. Monday was kind of eventful and I got to see a few different patients, and Jesus was really nice and trying to teach me a bunch of new things. On Wednesday, it was pretty boring, and I did not do very much. I got to talk a lot with one of the respiratory therapists, and she answered a lot of questions that I had about the department. At the end of Wednesday, it got kind of eventful, and I got to observe the doctor preform a diagnostic test on a patient.

b.    Educational Value- I learned a few new things this week during my time in the respiratory department. I learned a lot about some of the patient stuff on Monday, and a lot of stuff about the career path of a respiratory therapist on Wednesday.

c.     Professional Value- I learned a lot about the professionalism of the respiratory department this year. Mainly, on Wednesday, I got to talk a lot with the doctor, Kim about her career path. She was originally working as a physical therapist, but her employer decided to pay for her to go back to school. So she did, and she became a respiratory therapist. She said she did not like her job. The only thing she liked about it was the amount of freedom that she had. So yes, this week did have some sort of professional value for me.

Learning Report

      I.         What were your responsibilities or duties this week?

a.    I did not have any responsibilities or duties that I had to preform at all this week. It was pretty slow, so the doctors were not asking me to help with anything; they were just trying to teach me.

    II.         What new knowledge or skill did you learn this week?

a.    I learned a few new things this week during my time in the respiratory department. I learned a lot about some of the patient stuff on Monday, and a lot of stuff about the career path of a respiratory therapist on Wednesday.

  III.         What was the best thing that happened at the unpaid work-based learning site this week?

a.    The best thing that happened this week was a lot of different things. Mainly, how nice Jesus was, it really was fun. He was trying to teach me as much as possible, and he was taking me like all over the hospital. And on Wednesday, the best thing that happened to me was that I got to see an actual PFT test being preformed. It wasn’t too interesting, but it was a real diagnostic test that I got to observe, so that was cool.

  IV.         What was the worst thing that happened at the unpaid work-based learning site this week?

a.    The worst thing that happened this week was that on Wednesday, it was pretty slow and quiet. And Kim, the lady who I was observing, was kind of bitter, and not that nice to other people. But it was really funny. And I enjoyed her as a person.

    V.         If the “worst” was a mistake, how was it corrected?

a.    The worst was not a mistake, so there was no way to correct it.

  VI.         This Week was: Fair

Why? This week was fair because Monday was eventful, and Wednesday was not that eventful.

Experience Record

      I.         Technology Observed:

a.    Mac 500

b.    AirGas machine

c.     VMax machine

d.    a PFT test

e.    etc.

    II.         Diagnostic Procedures Observed:

a.    ABG test

b.    PFT test

  III.         Therapeutic Procedures Observed:

a.    Ventilator

b.    Medicine

c.     Trach

  IV.         Diseases/Disorders Observed:

a.    COPD

b.    Apnea

c.     Obesity

    V.         Medical Terminology/Abbreviations Encountered

a.    ABG- Arterial Blood Gas

b.    PFT- Pulmonary function test

c.     Code- Code blue

Learning Experience Journal

This week I was in the respiratory department. On Monday, I first walked in and introduced myself to Jesus and Mark. They were watching TV, but when I came in Jesus decided to go check on a patient to show him to me. So we walking into the patient’s room, and it was an obese 600 pound man. Jesus talked to the family for a while, and then took some blood from the patient. Then we went to the lab, and did a test on the blood, and the test had bad results because he accidently got venous blood instead of arterial blood. Then we went back upstairs and saw another patient who had a ventilator that he relied on to breathe. Then on Wednesday, I walked in and introduced myself to the woman who was in the office, and she said that there was nothing going on for a few minutes, and she asked me to wait outside. So I waited outside sitting in a chair for a while, and worked on my questions. Then Pricilla came in, and she started to talk to me for a bit. Then she left and I was still sitting there. Then finally Kim came out and took me around the ICU, but she didn’t really need to do anything, so she was talking to one of the nurses for a while. Then I started asking her questions, so we sat down and chatted about the job and some of the questions that I had. Then she showed me around the stock room. Then she got a call, so we went down to the radiology department to run a PFT test on a patient who was a walk-in. So Kim started the test, and like halfway through it, it was time for me to go, so I said goodbye and got Kim to sign my task sheet, and then I left. I had a pretty good week. I learned a lot of new things and had a lot of patient contact throughout this week.

Respiratory Therapy Questions

          I.     Explain the difference between a pulmonologist and an RRT

a.    A pulmonologist is an MD and an RRT is a registered respiratory therapist

        II.     Define the following:

a.    Aerosol- a type of gas

b.    Spirometry- a test that measures the forced expiratory volume in one second

c.     Bronchodilator- is a substance that dilates the bronchi and bronchioles, decreasing resistance in the respiratory airway and increasing airflow to the lungs

d.    Apnea- A sleep disorder when you are really overweight and cant breathe

e.    Aspiration- when you choke on our own vomit

f.      Hypoxia- disease in the blood

g.     Croup- coup

h.    Hiccough- mix between a hiccup and a cough

i.      Sneeze- discharging snot through your nostrils

      III.     Describe the components of ABG analysis.

a.    Blood analysis that tests for all of the different gasses in your blood

       IV.     Identify the normal values for PO2 and PCO2.

a.    PO2 and PCO2

         V.     Describe the characteristics of hemoptysis in relation to the potential bleeding site.

a.    When a patient presents with massive hemoptysis, the initial steps are to correctly position the patient, establish a patent airway, insure adequate gas exchange and cardiovascular function, and control the bleeding 

       VI.     Differentiate between PEEP and CHF

a.    CHF is Chronic Heart Failure, and PEEP is positive end-expiratory pressure

     VII.     Describe the purpose of a pulmonary function test.

   VIII.     Describe the procedure for a postural drainage.

a.    Drainage used in bronchiectasis and lung abscess.

       IX.     List the steps for adult one-person CPR

a.    Normal, compressions and breathing.

         X.     What are the benefits of an aerosol treatment?

a.    the use of an aerosol for respiratory care in the treatment of bronchopulmonary disease. 

       XI.     Describe atelectasis

a.    is the collapse of part or (much less commonly) all of a lung. Symptoms: Breathing difficulty; Chest pain; Cough.

     XII.     Describe the signs and symptoms of a spontainious pneumothorax

a.    A collapsed lung, or pneumothorax, is the collection of air in the space around the lungs. This buildup of air puts pressure on the lung, so it cannot expand as much as it normally does when you take a breath

   XIII.     Define tension pneumothorax

a.    Collection of air in the pleural cavity around the lungs that cause a lung to collapse.

    XIV.     Define the following:

a.    Pneumonectomy- removal of a lung

b.    Thoracotomy- removal of the thorax

c.     Trachestomy- removal of the trachea

d.    Lobectomy- removale of the obes

      XV.     Define the signs and symptoms of COPD

a.    Chronic Obstructive Pulmonary Disorder

    XVI.     Draw and label the components of the respiratory system

a.    Lungs, veins, arteries, trachea, blood, etc.

  XVII.     Define the following

a.    Emphysema- Stuff in your lungs

b.    Pneumonia- sickness where there is fluid in your lungs

c.     Bronchitis- inflammation on the bronchi

d.    Tuberculosis-a condition of the tuberculi

e.    Asthma- a shortage of breath, and problem with your lungs and bronchi

f.      ARDS- ARDS

XVIII.     Define the following

a.    Etiology- The study to eti

b.    Prognosis- a diagnosis

c.     Remission- being well for s while

d.    Exacerbation- exacerbation

e.    Relapse- back from remission

f.      Complication- a problem

g.     Sign- a symptom

h.    Symptom- some clue as to what is wrong

    XIX.     Describe the difference between a hemothorax and a pneumothorax

They are practically the same thing