I'm lacking some blood
Mrs T is 36yo and pregnant. She was complaining of eating ice all day and feels something is not right with her. her blood work came back with HGB 10. what type of anemia do you think she has.
Iron deficiency anemia.
she is also experiencing PICA
A 60 yo male is admitted to the hospital and lab work revealed WBC 8, hgb 14, plts 20.
vitals 100/70, hr 98, RR 18, temp 98
1. what is concerning with the above information?
2. what is his diagnosis
3. what are some nursing interventions
1. plts 20
2. thrombocytopenia: decreased production of plts
3. monitor for bleeding, check stools for occult blood, provide plts if needed for bleeding, place on bleeding precautions, fall prevention
your 35 yo obese male with social hx of smoking and ETOH 3-4x/week is complaining of sour taste the last month and heartburn. abd exam is negative.
1. what is his diagnosis
2. what are some nursing interventions
GERD
Avoid consuming: alcohol, spicy foods, chocolate, caffeine, fatty foods
Avoid eating before bed (approx 3 hours)
Stay sitting/standing for 30 minutes after meals
Prop head of bed up on 3” blocks
your patient was started on iron supplements and two weeks at his follow up appointment he complains that he is having dark stools and concerned for bleeding. your exam is negative.
what should you tell this patient
this is common with iron supplements. it will darken your stools.
Mr B. has been feeling numbness/tingling of his toes the last few months. work up was negative for diabetes but interestingly it showed low levels of B12 and hgb of 9. further work up was negative for any GI bleeding.
1. what time of anemia do you feel is the cause of his low hgb.
2. what is the cause of this anemia
3. what type of tx is recommended.
1. pernicious anemia
2. antibodies attack parietal cells = decrease in intrinsic factor which results in decrease of absorption of B12
3. IV B12 only since they lack the intrinsic factor to absorb it if given orally
Mr T is being treated for colon cancer.
lab work reveals Wbc 1, hgb 13, plts 125
vitals: 118/60, HR 60, RR 18, Temp 100.9
1. what is concerning about the above information for Mr. T
2. what are some interventions that would apply for this patient
1. WBC 1 = Neutropenia
2. Temp 100.9 is a priority due to high risk for infection
3. hand hygiene, monitor temp q4, no fresh flowers/plants, limit visitors (especially if ill), wear a mask in public, avoid public gatherings.
A 50yo AA male arrives to the EC with complaints of headache that started yesterday. he also has been having Chest pain that started this morning and progressively getting worse. labs are pending.
VS: 160/88, HR 100, RR 20, Temp: 100.8,
PMHX: Gout, Migraines, Sickle Cell Anemia, GIB, HTN/HL
1. What about his hx is concerning
2. what should you assess in this patient and why.
1. Sickle cell anemia- recessive disorder in which causes a sickle-cell shape within RBC’s leading to risk for occlusion
2. H/A: assess neurological status due to risk for CVA
Chest pain: assess cardiac due to risk for MI & resp status due to risk for PE
Mr V is receiving 1 unit PRBC for hgb of 8. within in 30min of transfusion he developed hives and BP is 90/40. temp at start of transfusion was 98 and now its 100.8.
what should you do??
1. stop the transfusion. notify provider
2. monitor vitals q5-15 min
3. maintain IV access with NaCL
4. fill out transfusion reaction form