difficult ones Flashcards
iron deficiency anemia clinical manifestation
Mild may be asymptomatic
Pallor
Glossitis (thick red tongue)
Cheilitis (chapped lips)
Symptoms of lack of oxygen in tissue:
*HA, paresthesia, burning of tongue
megaloblastic anemia
folic/b12 deficiency
clinical manifestation and diagnostic screening
Sore/red/beefy tongue (Glossitis)
B12 deficiency: neuromuscular symptoms
*weakness, paresthesia, confusion/dementia
CBC(MCV, Hgb/Hct), B12/folate levels
sca
Genetic disorder: autosomal recessive
*if both parents have sickle cell trait 1/4 chance baby will have it
Life expectancy 42-47 years
Abnormal form of Hgb causes RBC to stiffen and elongate (sickle shape) when O2 levels are low
If inherited from one parent then it will be less severe
sca complications
Embolic events:
MI
VTE
CVA (stroke)
PE
Issue related to decrease circulation:
Chronic leg ulcers( due to lack of O2 for healing)
Renal failure
thrombocytopenia
nursing management
pt education
plt transfusion
monitor for bleeding
avoid IM infections
avoid rectal temps/exams
avoid invasive procedures
pt/family teaching:
-symptoms of bleeding
-shaving
-avoid asparin
-what to do for nose bleeding:
*call if last 15mins and go to hospital if goes to 30mins
neutropenia
clinical manifesations
complications
risk of infections
*oppotunistic, pt own flora
may not have normal s/s due to low WBC
low grade fever very concering if neutropeic
*emergency: 100.4 or high with ANC <500
*need blood culture ASAP
*ABX within 1 hour
hemphilia tx
TX:
replacement of clot factors (cryoprecipitate)
bedrest during bleeding episodes
treat hemarthrosis with RICE (vasoconstriction), analgesia, immobilization
effects of chemo on normal tissue
acute
delayed
chronic
acute toxicity: during and after admin
*anaphylaxis, hypersensitivity, extravasation, N/V
delayed effects: numerous
*N/V, alopecia, rashes, bone marrow suppression, diarrhea/constipation
chronic toxicities: damage to organs
*heart, liver, kidneys, lungs
GI effects of radiation and chemo
anorexia:
*nausea, stomatitis (inflammation of mouth), appetite suppressant
tx:monitor wt, small freq meals, topical analgesia for stomatitis
consitpation:
tx: stool softeners, high fiber, fluid intake, activity
Diarrhea: replace fluids
N/V: prophylactic tx before sessions
other effects of chemo and radiation
neuro:
chemo brian
peripheral neuropathy
pulomnoary: pulmonitis
cardiac: dysrhythmias
reproductive: may lose fertility
*discuss preservation of ova/sperm
sspinal cord compression
Cause
S/s
Tx
cause:
cancer in epidural space or spinal cord
s/s:
-back pain, verebral tenderness
-motor weakness/sensory loss
-autonomic dysfunction (bowel/bladder)
*(looks like retention or incontinence)
management:
ER, radiation/surgery
superior vena cava syndrome
Cause
Ss
Tx
obstruction of superior vena cava by tumor
s/s:
facial/periorbital edema
distention of veins of head, neck, chest
HA, seizures
mediastinal mass on CXR
management:
ER
radiation at site
more sensitive chemo
hypercalcemia
metastatic disease of bone or multiple myeloma
*causes release ca from bone
s/s:
fatigue/weakness
hyporeflecia
cardiac dysrhythmias
kidney stones
management:
hydration (dilute it)
bisphosphates
diuretics
tumor lysis syndrome
rapid release of cellular contents
(tumor open up and the intracellular electrolytes get out)
hallmark signs:
hyperuricemia (gout)
hyperphosphatemia
hyperkalemia
hypocalcemia
watch for cardiac due to these
within 24-48 hours after starting chemo
management:
hydration
allopurinol (decreases uric acid)
electrolyte correction
phases of hiv
- acute infection 1-3 weeks
- asymptomatic infection 3 weeks - 3 months
*(HIV antibody test become positive) - symptomatic infection
- AIDS
