Wild Card
Provide 3 nursing management (teaching) points for a client with Lupus
avoid direct sunlight
pain management
sun block!
mild soaps and shampoos
Why is leukemia characterized by increased risk of infection and a weak immune system?
Bone marrow produces a large number of immature, defective, abnormal WBCs that cannot function appropriately.
Builds up the marrow and floods the blood stream.
What happens during sickle cell crisis?
deformed RBC collect in small vessels
What diagnostic test is used to confirm anemia?
CBC- specifically hemoglobin and hematocrit
What is an autologous blood donation?
Self-donated blood, collected ahead of an anticipated procedure.
What teaching is necessary for a patient prescribed an iron supplement?
dark stools
nausea/vomiting constipation
Take with orange juice
Do not take with milk, calcium or antacids
take on empty stomach
Provide 2 examples of when therapeutic immunosuppression is considered.
Cancer: chemotherapy and radiation
Autoimmune diseases
Organ Transplantation
List 3 symptoms common of a sickle cell crisis.
Severe pain (extremities and abdomen)
fever dyspnea
swelling of extremities skin irritation
chest pain jaundice
skin irritation
List 3 treatment options for anemia.
control bleeding B12 injections
Iron supplements blood transfusions
Medications: Procrit, Epogen, Aranesp
When will most severe reactions to a blood transfusion occur?
within the first 15 minutes/50ml
List 2 symptoms of thrombocytopenia
purpura
ecchymosis
bleeding in/from any body part
petechiae
List 3 examples of neutropenic precautions
No fresh flowers No fresh produce
Wear gloves, mask, gown Hand Hygiene
Patient dedicated or disposable equipment
Use HOT water for dishes/clothes/etc
List 3 treatments for symptom management during a sickle cell crisis.
Hydration Oxygen
Pain management (narcotics)
Blood transfusion of PRBC
Bedrest (decreases oxygen consumption)
What vitamin is associated with pernicious anemia?
What specific s/s are associated with this vitamin deficiency?
Vitamin B12
parasthesias/ difficulty walking/ beefy red, sore tongue
List 4 s/s of a blood transfusion reaction.
chills fever
tachycardia tachypnea/SOB
back pain itching
restless/apprehension/impending doom
hemoglobinuria facial flushing
what blood type is the universal blood donor?
Why?
O neg.
Absence of the (Rh), A and B antigens allows it to flow undetected in the body.
Which cancer is associated with a single, painless enlarged lymph node that progresses to general lymphadenopathy?
Non-Hodgkin's Lymphoma
You are providing education to a client with sickle cell disease related to risk factors for causing a pain crisis. List 3.
dehydration stress
extreme temperatures smoking
extreme exercise infection/illness
How can chronic hemorrhagic anemia occur?
List 2 specific examples.
Slow bleeding over time in the GI tract:
peptic ulcers, bleeding hemorrhoids, bleeding polyps, and cancerous GI tract lesions
benadryl oxygen
epi pen fluids
tylenol
The PN notices that the INR for a patient on coumadin is 8. Is this therapeutic?
What is the antidote for coumadin?
NO!! Therapeutic range for INR coumadin is 2.0-3.0.
Vitamin K
List 2 reasons to postpone vaccination.
Fever
immune deficiency disease
immunosuppressive therapy
administration of human immune globulin, plasma, or whole blood transfusion 6-8 weeks before the immunization.
Why is sickle cell disease most common in African-Americans?
the hemoglobin mutation trait is protective against Malaria (very common in Africa, and next the Middle East and India). This provided a survival advantage, so carriers were more likely to survive and reproduce, continuing the Sickle Cell trait.
How does the depression of bone marrow cause Aplastic Anemia?
Decreases the production of RBC, WBC, and platelets
What is your first priority when a client experiences a suspected transfusion reaction?
Stop the blood and start IV fluids in fresh tubing.
Save tubing and blood to send back to the blood bank