Charlie Cobalt 64 yo

Has been working in the factory for 35 yearsand is 1 year away from retirement. He comes in today c/ofatigue and SOB.

CBCRBC 2.5WBC 2.5Hgb 8.2Hct 20Platlets- 24,000

Dx:Aplastic Anemia

Tx:Blood TransfusionBone Marrow replacementAB’sCorticosteroidsNo more factory!

Nursing Dx:Potential for infectionActivity intolerancePotential for hemorrhageFearKnowledge deficit

Jimmy Sutton 8yo

Comes in complaining of severe fatigue, weakness, loss of appetite, and “sick”.

CBCRBC-3.2WBC- 40,000Hgb- 8.4Platlets- 23,000

Dx: Possible ALL

Leukemia is a cancer of the blood manufacturing centers.2 types: Lymphocytic and Myelogenous

2 types: Acute and Chronic

Confirm Dx?Bone marrow biopsy

Tx:ChemotherapyAx for infections (Cloudy urine, chest congestion)

due to neutropenia.

Nursing Dx:Potential for infectionActivity intoleranceImpaired mucus membraneKnowledge deficitFearPotential for hemorrhage

(Small needles)Nutrition: < body requirements

(Stomatitis)

Thomas Wheeling:In a fight after a soccer game.Unable to speak.CTClean and dress wounds.Labs:

HgB- 6.2HcT- 18.2

Transfuse Blood ASAPWhich? How?Signs of Reaction

Big feverFlushed/ItchingDyspnea

If seen do what?

Carlos is a 6 yo boy.He was brought in by his MotherC/O severe pain in his left kneeWhy?Obtain HxUS?History of HemophiliaHow?From Mom (Carrier) to son.Dx: Internal bleeding in joint.Tx: Prevent injury, Infuse clotting factorsNursing Dx: Potential for…

Kris is a 3 yo female brought inby her mother.Mother reports she fell on tiled floorat home while playing with her brother. Bruising of face and body covered

with purpura and petechiae.Abuse?

Labs:HgB- 13.8Hct- 39Platelets- 50,000

Dx: ThrombocytopeniaTx: Prevent further injury!!!

Small needles

Sally is a 8 yo with a history of Leukemia.She was brought in by her father with c/o“Not feeling well” and cloudy urine.She finished her last round of chemo 3 daysago.Labs:

WBC: 500Platlets: 74,000

Dx: Leukemia, Stomatitis, Thrombocytopenia, Urinary infectionTx:Neutorpenic precautionsSoft foodsPrevent injuryAB’sNursing Dx: Potential for..

Impaired oral mucus membranes

Carlton is a 28 yo male with a historyof sickle cell anemia. Comes in todayc/o severe abd. and leg pain.

Dx: Sickle Cell CrisisHow?

Stress on bodyDehydrationInfectionSmoking

Tx: Treat the painInfuse? Hydroxyurea?Treat the cause

Nursing Dx: Pain! Knowledge deficit?

Michelle is a 17 yo female with c/o severe weakness,fatigue, and numbness and tingling in arms,and cold all the time

History:Partial gastrectomy 8 months ago for weight issues

Labs:HgB: 8.1HcT: 32

Dx: Pernicious Anemia

Tx:B12 1 x month for life

Nursing Dx:Activity intolerance (rest periods)