Lab Values
normal WBC lab value
5,000-10,000
Leukemia treatment
chemo
radiation
bone marrow transplant
stem cell transplant
Take during pregnancy to prevent spina bifida and cleft palates
folic acid
hemophilia manifestations
bleeding - any type and any orifice
pain
anesthesia
paralysis from nerve compression caused by hematomas
acute vs chronic leukemias
acute: rapid progression
chronic: slow progression
normal PLT count
150,000-400,000
What are the 2 admission requirements for hospice care
1. pt must desire services and agree in writing that only hospice care can be used to treat illness
2. pt must be considered eligable by 2 physicians (must certify that pt prognosis is terminal), and that the pt has 6 months or less to live
What do you avoid when taking oral iron supplements
milk / calcium
treatment for hemophilia
infusion of deficient factor
infusion of desmopressin (DDAVP)
Sickle Cell Anemia manifestations
due to anemia: fatigue, pallor, SOB
due to vasoconstriction: pain & swelling and organ damage
jaundice
increased risk for infection
Normal Hct count for men and women
men: 40-50%
women: 37-47%
Leukemia manifestations
swollen and painful lymph glands and LUQ
increased risk for infection
bone pain
neutropenia
low grade temp
signs of anemia: pallor, weakness, SOB
signs of thrombocytopenia: bruising/bleeding
spleenomegaly, hepatomegaly, lymphadenopathies
Vitamin B 12 anemia
tachycardia, tachypnea, SOB, dizzy, fatigue, weight loss, tinnitus, peripheral neuropathy, paresthesia, numbness, confusion, depression, impaired balance, impaired taste, dementia, visual disturbances
SE of neupogen
aching/pain in bones/muscles
diarrhea
constipation
hair loss
headache
tired feeling
skin rash
nosebleeds
injection site reactions
SPLENOMEGALY (MONITOR CLOSELY FOR LUQ PAIN)Main diagnostic feature in Hodgkin's Disease
Presence of Reed-Sternberg cells in lymph biopsy
Normal Hbg count for men and women
men: 14-16.5 g/dl
women: 12-15 g/dl
Common & systemic S/S of Hodgkin's Disease
common: painless enlarged lymph nodes in neck, underarm, groin
systemic: fever, night sweats, fatigue, weight lossSickle cell anemia precipitating factors
dehydration, cold temps, infection, environments with low O2, emotional/physical stress, pregnancy, may appear w/o cause
Terms with WBC abnormalities
leukocytosis
leukopenia
neutropenia
agranulocytosis
leukocytosis: >10,000
Leukopenia: <5,000
Neutropenia: <1,000
Agranulocytosis: <500
tx for Idiopathic Thrombocytopenia Purpura (ITP)
if >100,000: just observe
glucocorticoidsIVIG
plt transfusionsevere splenomegaly
Normal RBC count for men and women
men: 4.2-5.4 million
women: 3.6-5.0 million
7 warning signs of cancer are:
C: change in bowel/bladder habits
A: A sore that doesn't heal
U: unusual bleeding/discharge from any orifice
T: thickening/lump in breast or elsewhere
I: indigestion/difficulty swallowing
O: obvious change in wart/mole
N: nagging cough/hoarseness
Sickle cell treatment
aggressive hydration
analgesia
antibiotics
blood transfusion
hydroxyurea
blood transfusion
peripheral stem cell transplant
Name the bleeding precautions (10)
1. Soft bristle toothbrush/ no flossing
2. electric shaver
3. shoes/slippers in house
4. clutter free environment
5. use stool softeners daily6. avoid rectal temps/suppositories/enemas
7. Avoid sexual intercourse when plt count low
8. Do not blow nose
9. Apply direct pressure to lacerations and/or ice for no less than 5 minutes until bleeding stops
10. Procedures like injections, blood draws, etc are kept to a minimum
Neutropenic precautions (9)
1. frequent hand washing/ hand sanitizer for everyone
2. avoid crowds, if you must go into the public, wear a mask
3. avoid obviously sick people, small children, and pets
4. Wash fruits/vegetables before eating them
5. NO rectal temps, suppositories, or enemas due to risk of infection
6. No live plants/cut flowers in the home
7. Avoid standing bodies of water in appliances
8. Be in a private room if hospitalized
9. Monitor daily temp and if >100.4 =, rapid antibiotics to prevent sepsis