Test 9 Flashcards
- Hodgkin’s Patho and manifestations
Pathophysiology and Etiology: Reed-Sternberg cells
Manifestations:
Painless lymph node enlargement
Epigastric pain, fullness
Weight loss, anorexia, fatigue, weakness
Low-grade fever, pruritus, night sweats
Anemia, thrombocytopenia
Poor resistance to infection
- Hodgkin’s diagnosis/planning, treatment plan and assessment hx
Treatment: Goal is to cure the disease. Good prognosis
Assessment History:
Symptoms, Mononucleosis
Physical assessment: lymph nodes
Diagnosis and Planning
Ineffective airway clearance
Impaired gas exchanged.
Infection
Impaired skin integrity.
- Hodgkin’s Interventions
Assess respiratory status.
Administer oxygen.
Prepare for intubation.
Infectious disease precautions
Support and protect bony prominences.
- Iron supplementation client education (slide 5)
Increased iron intake
Collaborate with dietitian to ID foods high in iron.
Administer iron supplement (IM Z-track)
Absorption best with citrus fruit or empty stomach
Client education: dark stool black or green and mild constipation- stool softener okay. No antiacids and take between meals.
- Iron rich foods
Red meats
Lentils/Beans
Egg yolks
Spinach
Dried fruit
Dark leafy greens
Peanut butter
Poultry
- Sickle cell crisis interventions/client education, risk, priority (slide 8)
Risk for infection (avoid large crowds)
Priority is hydration for children.
Nursing Interventions:
Administer prescribed analgesics.
Provide 3000mL of daily fluid.
Administer oxygen.
- Beta-thalassemia manifestations (Slide 10)
Cooley’s anemia:
Bronzing of the skin
Listlessness
Anorexia
Fever
Beta: pallor
- Pernicious anemia interventions, education (slide 12)
Glossitis and stomatitis: soft, bland diet, small frequent meals and good oral care
Permanent neurologic deficit: encourage and assist with ambulation, supervision.
Teaching: Administer of vitamin b12; diet
- Leukemia manifestations
Severe anemia
Infections
Fatigue
Easy bruising
Fever
Enlarged spleen and lymph nodes.
Internal or external bleeding
Bone pain
Joint swelling
- Leukemia priority/risk and interventions
Priority/Risk:
Hemorrhage, infection, activity intolerance, disturbed body image, anxiety and fear
Interventions:
Monitor platelet counts- hemorrhage greatest risk bleeding precautions.
Implement transmission precaution.
Assess for signs of bruising and petechiae, report hematuria or epistaxis.
- Hypovolemic anemia manifestations acute and chronic (Slide 3)
Acute:
Reduced urine output
Altered consciousness.
Extreme pallor
Chronic:
Pallor
Fatigue
Chills
Tachycardia
Postural Hypotension
Rapid Respiratory rate
- Chemotherapy dietary changes, expected lab values.
Labs after Chemo:
Platelets, WBC, RBC all lower
Dietary Changes
Limit liquids at mealtime
Sugar-free gum or mints for bitter taste
Low fat foods/small frequent meals
- Bone marrow aspiration client education
Very little discomfort mostly pressure and short lived, but no baths until site heals, no ASA products.
- Neutropenic precautions
No fresh, fruit
NO salad bars.
Bottled water only.
Strict handwash
Wear a mask when going places.
Private room
- Multiple myeloma patho, complications, diagnostic tests (Slide 18)
Pathophysiology and Etiology: Malignancy involving plasma cells.
Osteoclasts break down bone cells, resulting in increased blood calcium and pathologic fractures.
Osteolytic tumors: “punch out” or “honeycombed” appearance in bones.
