Medical-Surgical Nursing, 8th Ed., Ignatavicius & Workman, 2015 | Registered Nurse (RN) School Study Aid
Sickle Cell Anemia Assessment
- Hemoglobin S (Genetic Defect)
- Sickle Shaped RBCs
- Jaundice
- Vaso Occlusive Crisis
- Fever
- Priapism
- Severe Pain
- Prominent in African Americans
- May be Asymptomatic
- Increased Risk of Infection
Iron (Ferrous Sulfate)
- Ferrous Salts
- Anemia
- GI Distress
- Nausea and Vomiting
- Dark Stools
- Take Between Meals
- Liquid can Stain Teeth
- Keep out of Reach from Children
- Caution with GI Disorders
- Avoid Antacids
Sickle Cell Anemia Interventions
- Increase Hydration
- Analgesics
- Oxygen
- Warm Compress
- Bone Marrow Transplant
- Hydroxyurea
- Avoid High Altitudes
- Prophylactic Antibiotics
- Avoid Strenuous Exercise
- Vaccines
Cobalamin (Vitamin B12)
- Vitamin B12
- Vitamin Deficiency
- Pernicious Anemia
- Hypokalemia
- Arthralgia
- Dizziness
- IM Injection for Pernicious Anemia
- Never Give IV
Polycythemia Vera Disease
- JAK2 Mutation leading to increased red blood cells
- Tyrosine Kinase
- Erythromelalgia
- Pruritus
- Often After Hot Shower
- Headache
- Phlebotomy
- Aspirin
Leukemia Assessment
- Immature WBCs
- Recurrent Infections
- Easy Bruising
- Bleeding
- Anemia
- Fatigue
- Weight Loss
- Bone Pain
- May Have Normal or High WBC Count
Leukemia Interventions
- Bone Marrow Aspiration
- X-Rays
- Chemotherapy
- Bleeding Precautions
- Neutropenic Precautions
- Strict Asepsis
- Bone Marrow Transplant
- Blood Transfusions
- Monitor Temperature Elevations
- Adequate Nutrition
- Imatinib (Gleevec) for Chronic Myelogenous Leukemia (CML)
Bleeding Precautions
- Hard Foods
- Aspirin Products
- Blowing Nose Forcefully
- Straining During BMs
- Enemas or Rectal Suppositories
- Pads and Monitor Menstruation
- Soft-bristled Toothbrush
- Electric Razor
- Limit Needle Sticks
- Smaller Needle Size
Hodgkin's Lymphoma Assessment
- Lymph Node Cancer
- Contiguous Spread
- Painless Lymphadenopathy
- Constitutional B Signs
- Night Sweats
- Fever
- Weight Loss
- Bimodal Age Distribution
- Reed-Sternberg Cells
Hodgkin's Lymphoma Interventions
- Biopsy
- Staging
- Radiation
- Chemotherapy
- Treat Side Effects of Therapy
- Secondary Cancer Screening
Non-Hodgkin's Lymphoma Assessment
- Lymphatic Cancer
- Non-Contiguous Spread
- B or T Cells
- Painless Lymphadenopathy
- Constitutional B Signs
- Night Sweats
- Fever
- Weight Loss
- Mediastinal or Abdominal Mass
- Older Adults
- > 60 Subtypes
Heparin Induced Thrombocytopenia (HIT)
- 5-10 Days After Heparin Exposure
- Heparin-Platelet Factor 4 Complex
- Autoantibodies Form Against Complex
- Heparin-Platelet Factor 4-Antibody Complex Binds Platelets
- Platelet Aggregation
- Procoagulant Release
- Thrombocytopenia
- Serotonin Release Assay (SRA)
- Stop Heparin, Start Direct Thrombin Inhibitor
Types of Blood Products
- Whole Blood
- Packed Red Blood Cells
- Fresh Frozen Plasma
- Immunoglobulins
- Clotting Factors
- Albumin
- Platelets
- Use within 24 Hours
- Washing Removes Antibodies
- Irradiation Destroys WBCs
Blood Transfusion Administration
- Proper Patient Identification
- Large Bore Needle
- Y Tubing
- Baseline Vital Signs
- Slow IV Infusion
- Monitor During First 15 Minutes or 50 mL of Blood
- Monitor for Reactions
- Do Not Add Anything To Same IV Line
- No Dextrose or Lactated Ringers
- Jehovah's Witnesses, No Transfusions
Transfusion Reactions
- Acute Hemolytic
- Febrile, Non-Hemolytic
- Mild Allergic
- Anaphylactic
- Circulatory Overload
- Sepsis Reaction
- Transfusion-Related Acute Lung Injury (TRALI)
- Massive Blood Transfusion
Blood Types and Compatibilities
- No Antigens (Type O Blood)
- Universal Donor
- A Antigen (Type A Blood)
- B Antigen (Type B Blood)
- AB Antigen (Type AB Blood)
- Universal Recipient
- Rh (Rhesus) Antigen
- Never Rh+ to Rh-
- Blood Transfusion
- Obstetric Patient