Med Surg

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Author:
abutler5
ID:
226683
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Med Surg
Updated:
2013-07-11 11:07:50
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Chapter 28
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Nursing Care for Patient with blood disorders
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  1. A condition in which there is a deficiency of RBC or hemoglobin or both
    Anemia
  2. Anemia Symptoms?
    SOB, fatigue and weakness
  3. Causes of Anemia:
    • 1. impaired production of RBC
    • 2. increased destruction of RBC
    • 3. massive or chronic blood loss
  4. Signs and Symptoms of anemia?
    pallor, tachycardia, tachypnea, irritability, fatigue, and SOB
  5. Diagnostic Tests for Anemia?
    CBC -- RBC, WBC, hemoglobin and hematocrit and iron levels
  6. Iron supplements should be taking in conjunction with what to enhance absorption?
    Vitamin C
  7. type of anemia in which the bone marrow becomes fatty and incapable of producing the needed numbers of RBC
    Aplastic Anemia
  8. what is a result in aplastic anemia
    pancytopenia == a decreased number of all formed elements
  9. The most definitive diagnostic test for aplastic anemia
    bone marrow biopsy == because bone marrow is essentially dead == pale, fatty, yellow fibrous tissue not red, gelatinous tissue
  10. Erythopoietin/ Epogen
    stimulates the production of RBC
  11. Filgastim/Neupogen
    stimulates the production of WBC
  12. Sickle cell anemia is inherited ? T/F
    True
  13. What can cause a sickle cell crisis?
    hypoxia or dehydration
  14. Clinical manifestations of Sickle cell anemia?
    • Stasis ulcers
    • Stroke
    • Heart Failure
    • Hand and foot syndrome
  15. Signs and symptoms of Sickle Cell
    • Pain and swelling in joints (elbows and knees)
    • abdominal pain
  16. Therapeutic Interventions for Sickle Cell
    • Oxygen
    • IV and oral fluids
    • Analgesics
    • Blood transfusion
  17. Patient Education for Patient with Sickle Cell
    • prevention of acute episodes
    • avoid strenuous exercise
    • alcohol
    • no flying or mountain climbing
  18. Polycythemia
    • changes in the RBC cell count
    • the blood becomes so thick with and overabundance of RBC
  19. Therapeutic Measures for Polycythemia?
    • therapeutic phlebotomy -- withdrawal of blood 
    • first every other day, then every 2-3 months
  20. Disseminated Intravascular coagulation
    in a short period all of the clotting factors are exhausted and clots can no longer be formed === results in bleeding from everywhere
  21. What causes DIC?
    trauma
  22. Signs and symptoms of DIC?
    Early == petechiae, ecchymoses, bleeding at venipuncture site
  23. Diagnostic tests for DIC?
    PT and PTT == prolonged
  24. Therapeutic Measures for DIC?
    Administration of Vit K, Fresh frozen plasma, platelets, cryoprecipitate
  25. Hemophilia occurs in what type of patients?
    Young males
  26. What is Hemophilia?
    a group of heredity disorders that result from a severe lack of specific clotting factors 
  27. Signs and Symptoms of hemophilia?
    • bleeding into muscles and joints
    • Severe bleeding episodes can cause joint deformities
  28. A malignant disease of the WBC that affects all age groups ...
    Leukemia
  29. In Leukemia what happens to the immature WBC?
    the generate in an explosive fashion
  30. What is a complication of Leukemia?
    Anemia -- because too many WBC are being produced and not enough RBC are being produced
  31. What is complication of having few mature WBC in leukemia
    Risk for infection, to few mature WBC to fight off infection
  32. Therapeutic Measure for Leukemia?
    Chemotherapy
  33. Some Nursing interventions for patients undergoing chemotherapy?
    • Keep away from large crowds
    • No raw vegetables/ fruit or flowers
    • hand washing
  34. A deadly cancer of the plasma cells in the bone marrow?
    Multiple myloma
  35. Complications of multiple myeloma?
    pathological fractures
  36. Signs and symptoms of Multiple Myeloma?
    • Skeletal pain
    • hypercalcemia
  37. How do you treat Hypercalcemia in patients
    Give Fluids
  38. What are patients with multiple myeloma at risk for?
    Risk for injury/falls
  39. Cancer of the lymph system, determined by the presence of Reed Sternberg Cells
    Hodgkins Disease
  40. Sign of Hodgkin's disease?
    Swollen/painful lymph nodes == biopsy shows presence of reed sternbergs cells
  41. First priority for a patient with Hodgkins disease?
    Airway management
  42. What should patients with Hodgkins disease stay away of and why?
    Alcohol because it can induce pain
  43. NonHodgkins
    • Presence of Painless, swollen lymph nodes
    • absence of Reed Sternberg Cells
  44. Slenomagaly
    Enlarged spleen
  45. splenectomy
    removal of spleen
  46. What is ordered preoperatively for a splenectomy?
    Vit K to correct clotting factor deficiencies
  47. Complications from a Splenectomy?
    Respiratory problems == spleen is under diaphragm ----> pneumonia and atelectasis

    infections ---> spleen has a role in the immune response

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