Deck 12_Hematology

Question 1

What are the nursing interventions for patients with sickle cell disease?

Answer 1

HOP

• Hydration – gather supplies and start an IV-sickle goes back to normal (post-op needs hydration)
• Oxygenation – place O₂ prior to all Rxs; then put the patient on pulse oximetry
• Pain control – strong opioids (choice of med) + PCA pump; believe the patient! PCA can be controlled by the patient. Basal rate and top themselves off

Question 2

What are some overall nursing considerations for patients with a hematological disease?

Answer 2

• Bleeding precursor
• Inadequate WBC (NEUTREPENIA)

1. Assess for infection with Neutropenia (no children or standing water in room)
2. Ensure no sick visitors
3. Get blood culture
4. Start broad spectrum antibiotics
5. Ensure no flowers in patient room
6. Use bleeding precautions for any patient with thrombocytopenia

Question 3

What are the nursing considerations for the infusion of blood products, including age related considerations and possible electrolyte problems?

Answer 3

• Transfuse ONLY over 4 hours
• Stop their IVFs during transfusion
• 4 hrs max-packed blood products
• Possible reactions are seen in the first 30 mins
• IV solution that you can hang with blood products- normal saline
• Age related- recommendation to stop the maintenance fluid due to overload.
• Electrolyte-potassium (hyperkalemic)

Question 4

What are the signs and symptoms that a patient with neutropenia has?

Answer 4

S/S of a patient with neutropenia

• Risk for infection
• Low grade fever because of infection

Risk of infection is increased because these leukemic WBCs do not mature; therefore, the number of mature infection-fighting cells, or neutrophils, decreases. This is a condition known as neutropenia.

Low-grade fevers are commonly observed upon diagnosis in response to minor infections

Question 5

Electrolyte Abnormality with Transfusing blood products

Answer 5

Hyperkalemia (The older it is the more of a risk)

Question 6

What should the nurse do during Blood Transfusion?

Answer 6

• Stay with patient first 15-30 min and assess vital signs immediately before the transfusion starts
• Have patient report unusual sensations