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.
- Thrombocytopenia nursing actions (Slide 22)
Manage/ minimize bleeding (Soft toothbrush, no razors)
- Hemophilia client education during bleeds, manifestations (Slide 23)
Manifestations
Oozing
Severe bleeding
Bleeding in joint
Joint pain
Client education
Conserve energy
Ways to prevent further episodes.
Rest during bleeds
Elevate area.
Apply ice.
- Aplastic anemia manifestations (Slide 20)
Weakness, fatigue, opportunistic infections
Unusual bleeding, petechiae, ecchymosis
Enlarged spleen and abdominal pain.
- Mononucleosis client education (Slide 8)
Inspect throat; palpate lymph nodes; encourage fluid; soft; bland foods; cool liquids.
Emotional support
Teaching: rest, withhold donating blood, avoid contact sport.
- Lymphedema complications, manifestations
Complication:
Infection and Ulcer
Manifestation:
Swelling of affected area.
Skin is tight, firm, shiny, brawny.
Weeping or oozing
- Lymphedema nursing management
Skin assessment
Exercise
Elevation
Elastic garments
Mechanical devices
Emotional support
- Iron deficiency anemia clients at risk (Slide 5)
Clients with malabsorption disease
Lack of education or financial ability regarding nutrition
Clients with an unhealthy diet
- Know lab values for: HCT, WBC, Platelets
a. HCT: Male: 40-54%gdL Female: 38-47%gdL
b. WBC: Male 5,000-13,000mm3 Female: 5,000-10,000mm3
c. Platelets:150,00o-450,000mm3
- Go back over droplet, contact, airborne, and protective environment.
Airborne precautions to protect against droplet infections smaller than 5 mcg.
(Measles, varicella, pulmonary or laryngeal tuberculosis).
Droplet precautions protect against droplets larger than 5 mcg and travel 3 to 6 ft from the client.
(Streptococcal pharyngitis or pneumonia, Haemophiles influenzae type B, scarlet fever, rubella, pertussis, mumps, mycoplasma, pneumonia, meningococcal pneumonia and sepsis, pneumonic plague).
Contact precautions protect visitors and caregivers when they are within 3 ft of the client against direct client and environmental contact infections.
(Respiratory syncytial virus, shigella, enteric diseases caused by micro-organisms, wound infections, herpes simplex, impetigo, scabies, multidrug-resistant organisms).
Protective environment is an intervention (not type of precautions) to protect clients who are immunocompromised. This includes clients who have had an allogeneic hematopoietic stem cell transplant.
- Hemolytic Anemia: Medical, Surgical and Nursing Management
Medical Management
Removing the cause
Corticosteroids
Blood transfusion
Surgical Management
Splenectomy
Nursing Management
Health history
Supportive care
Medication
Teaching measures of self-care
Arrange follow-up evaluation.
