hematology- anemia

7/24/2019 HEMATOLOGY- Anemia

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Aplastic Anemia

Kevin Nones


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Nursing Diagnosis

Imbalance nutrition less than theneeds associated with N/V

Activity intolerance related toreduced oxygen supply to the CNS

leeding

!is" o# in#ection associated withinvasive measures$ reduction inimmunological


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Corrina Angeles

IRON DEFICIENCY

ANEMIA


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Activity intolerance

Shortness o# breath doing simple tas"s

Irregular heart rhythm

%allor

&ea"ness

Di''iness

(eadaches

Depression

Sore tongue

(ypothermia

!estless legs syndrome

%ica

)oss o# interest in wor"* recreation* relationships* andintimacy+

Iron defciencyproblems


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Hypothermia Imbalancedbody temperature* ine,ectivethermoregulation

Restless le!s syndromeimpaired peripheral tissueper#usion* Impaired com#ort*Disturbed sleeping pattern

"ica !is" prone healthbehavior

#oss o$ interest in %or&'recreation' relationships'and intimacy sexualdys#unction* impaired socialinteraction* social isolation

Others

!is" #or delayed development-children.

Dys#unctional #amily processe

Anxiety

ear

De0cient "nowledge

Activity intolerance (hortness o$ breath doin!

simple tas&s Impaired 1as2xchange* Ine,ective breathingpattern

Irre!)lar heart rhythm

Ine,ective Cardiac 3issue %er#usion*Decreased Cardiac 4utput

"allor De0cient 5uid volume

*ea&ness !is" #or #all* sel# carede0cit

Di++iness !is" #or in6ury Headaches$ Acute %ain

Depression Ine,ective Cerebral3issue %er#usion* ailure to thrive*impaired social interaction* socialisolation* ris" #or suicide

(ore ton!)e !is" #or aspiration*

Iron defciencyproblems


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VI3 89 D2ICI2NC:

)IAN 1


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89 De0ciency %roblems

Acti,ity Intolerance Ine,ective tissue per#usion

Imbalanced N)trition #ess than-ody Re/)irements

Constipation/Diarrhea !is" #or In#ection

!is" #or de0cient 5uid volume

De0cient Knowledge regarding condition*

prognosis* treatment* sel#


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Vit+ = De0ciency

>ustin Antes


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%ossible Nursing %roblems

Activity intolerance related to wea"nesssecondary to decreased tissue o9

Imbalanced nutrition related to less

than body re7uirements related to lac"o# motivation to coo" andunderstanding o# nutritional needs

De0cient "nowledge * related to lac" o#in#ormation about a well


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2xpected 4utcomes

Verbali'e the importance o# ta"ing#olic acid supplements and eating abalanced diet

!eturn to previous level o# physicalenergy+

Consume a balanced diet* including#oods containing #olic acid


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ANEMIA 0 INCREA(ED CE## DE(1R2C1ION3HEMO#Y1IC ANEMIA4


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(2?4):3IC AN2?IA


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!2VI2& @ ANA34?: %(:SI4)41:


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DI2!2N3 3:%2S 4 1)4IN C(AIN

2%SI)4N C(AIN -B23A C(AIN -A)%(A C(AIN -23A C(AIN -1A??A C(AIN -D2)3A C(AIN -


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2)2C3!4%(4!2SIS


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SICK)2 C2)) DIS2AS2


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SICK)2 C2)) DIS2AS2

( AA( AS( AS( SS


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SICK)2 C2)) DIS2AS2%A3(%(:SI4)41:

%4IN3 ?3A3I4N IN 3(2 23A C(AIN< 8 NC)243ID2A)32!A3I4N IN 3(2 3!ANSC!I%3I4N 4 A?IN4 ACIDVA)IN2 IS INS2!32D INS32AD 4 1)3A?IC ACID 4N 3(2 23A 1)4IN S3C3!2 AN4!?A)I3:


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SICK)2 C2)) DIS2AS2 S/Sx

AN: (:%4EIC C4NDI3I4N23A 1)4IN AN4!?A) %!43!SI4N(2?41)4IN &I)) %!2CI%I3A32 IN34 12)(2?41)4IN S3!C3!2S 4!?2D I!4S %4):?2!SICK)2 C2)) AN2?IAS%)2N4?21A): (2%A34?21A):(I1( NC4N>1A32D I)I!IS)I1(3 >ANDIC2I)I S34N2S%AIN A33ACKS!23IC)4C:34SIS2N)A!12?2N3 4 3(2 4N2S IN 3(2 AC2 AND SK))


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SICK)2 C2)) DIS2AS2 S/Sx

%AIND2)A:2D 1!4&3(VISA) %!4)2?SA34S%)2N2C34?:!2F2N3 IN2C3I4NS


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(:%4EIC C4NDI3I4N

(I1( A)3I3D2S2V2!2 2E2CIS2AN2S3(2SIA @ 4%2!A3I4NIN2C3I4ND2(:D!A3I4NIN)A??A3I4N


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S2V2!2 (:%4EICC4NDI3I4N

%AIN A33ACKSVAS4 4CC)SIV2 A33ACK!? 2E%ANSI4N

SICK)2 C2)) DIS2AS2 C(!4NIC


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SICK)2 C2)) DIS2AS2 C(!4NICS2V2!2 (:%4EIC C4NDI3I4N


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SICK)2 C2)) C!ISIS

VAS4 4CC)SIV2 C!ISISA%)AS3IC C!ISISS2F2S3!A3I4N C!ISIS(2?4):3IC C!ISIS


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VAS4 4C)SIV2 C!ISIS

AC32 C(2S3 S:ND!4?2!AIN C4?%)ICA3I4NS%)?4NA!: (:%2!32NSI4N4!1AN DA?A12)INDN2SSSKIN )C2!S

"RIA"I(M


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3!2A3?2N3

(:D!A3I4N4)IC ACID AND %2NICI))INANA)12SICS2EC(AN12 4! )44D 3!ANSSI4N @ I!4N )4ADIN1C(2)A3I4N(:D!4E:!2AA!1ININ24N2 ?A!!4! 4! S32?C2)) 3!ANS%)AN3


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N!SIN1 IN32!V2N3I4NS

8+ (:D!A3I4N

9+ ?anaging pain

G+ %reventing and managing in#ectionsH+ Vaccinations

+ ?inimi'ing de0cient "nowledge

+ %romoting coping s"ills

J+ ?onitoring and managing potential complications+ %romoting home and community based care

=+ Stem cell transplant and gene therapy


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3(A)ASS2?IA


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3(A)ASS2?IA

N4!?A)3!AI33!AI3A2C32D


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A)%(A 3(A)ASS2?IA%A3(4%(:SI4)41:

A%)(A 3(A)ASS2?IA


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A%)(A 3(A)ASS2?IA%A3(4%(:SI4)41:


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A)%(A 3(A)ASS2?IASI)2N3 CA!!I2!3(A)ASS2?IA 3!AI3( ( DIS2AS2 -H(2?41)4IN A!3S -HAS:?%34?A3IC?I)D AN2?IAS2V2!2 AN2?IA -2E3!AVASC)A! (2?4):SIS.(:D!4%S 23A)IS


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3!2A3?2N3

4)IC ACID2EC(AN12 4! )44D 3!ANSSI4N @ I!4N )4ADIN1C(2)A3I4N4N2 ?A!!4! 4! S32?C2)) 3!ANS%)AN3


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23A 3(A)ASS2?IA


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23A 3(A)ASS2?IA


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23A 3(A)ASS2?IA

3(A)ASS2?IA ?IN4!3(A)ASS2?IA IN32!?2DIA3(A)ASS2?IA ?A>4!AS:?%34?A3IC INC!2AS2D ( A9 ( S2V2!2 AN2?IA @ ?A: !2FI!2 2%IS4DIC )44D 3!ANSSI4NS2V2!2 AN2?IA @ )44D 3!ANSSI4N 4! )I2


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%A!4E:S?A) N4C3!NA)

(2?41)4IN!IA


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C4?%)2?2N3 %!432IN @ ?2?!AN2

A33ACK C4?%)2E


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%A!4E:S?A) N4C3!NA)

(2?41)4IN!IA

ACFI!2D IN3!INSIC (2?4):SISDIS2AS2 4 ?:2)4ID S32? C2))?3A3I4N 4N E C(!4?4S4?2S @ %I1 A 12N2D22C3IV2 C(4N 4N C2)) ?2?!AN2 A1AINS3 C4?%)2?2N3 C(4N%!4N2 34 A33ACK : C4?%)2?2N3 %!432IN!C &I)) 2 D2S3!4:2D IN 3(2 CI!C)A3I4N


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%A!4E:S?A) N4C3!NA)(2?41)4IN!IA S/Sx

C(!4NIC (2?4):SIS%ANC:34%2NIAIN3!AVASC)A! (2?4):SISINC!2AS2D N4C3!NA) (2?41)4IN!IAC49 !23AIN IN )44D D!IN1 3(2 NI32DA!K !IN2 D!IN1 3(2 NI322S4%(A12A) S%AS?2!2C3I)2 D:SNC3I4NAD4?INA) %AIN%)?4NA!: (:%2!32NSI4N


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%N( )AS

IN3!AVASC)A! AN2?IAINC!2AS2D )D(V2!: )4&/N4 (A%341)4IN)4& C:34?23!:


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3E3

S32!4IDS

3

&A!A!IN

C(2?43(2!A%:


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%N( 3!2A3?2N3

S32!4IDS&A!A!IN)44D 3!ANSSI4NC(2?43(2!A%:

2AS2D !2D C2)) D2S3!C3I4NN3!AC4!%SC)A!


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2AS2D !2D C2)) D2S3!C3I4NN3!AC4!%SC)A!

I??N2 ?2DIA32D


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I??N2 ?2DIA32D(2?4):SIS

IS4 AN3I4D:A34 AN3I4D:

N4N


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N4N I??N2 ?2DIA32D (2?4):SIS?2C(ANICA) CAS2


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)2C3!2 4N !IDA:


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&C DIS4!D2!S

%!4)I2!A3IV2 DIS4!D2!


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%!4)I2!A3IV2 DIS4!D2!4 &C

8+ !2AC3IV2 %!4)I2!A3I4N SI?%)2 )2K4C:34SIS

)2K2?4ID !2AC3I4N

9+ N24%)AS3IC %!4)I2!A3I4N )2K2?IA

):?%(4?A

AC32


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AC32)2K2?IA/):?%(4?A

?4!2 %!4)I2!A3IV2AS3 %AC2DA11!2SSIV2)A!12 C2))SINDI2!2N3IA32DI??A3!2N4N NC3I4NA)


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C(!4NIC )2K2?IA/):?%(4?A

)2SS %!4)I2!A3IV2S)4& %AC2D)2SS A11!2SIV2S?A)) C2))SDI2!2N3IA32D?A3!2?INI?A) NC3I4N


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DIA1N4S3ICS

12N43:%IN1%(2N43:%2?4!%(4)41:C)INICA) 2A3!2S4N2 ?A!!4& AS%I!A32?A!K2!S


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3!2A3?2N3

C(2?43(2!A%(:!ADIA3I4N?/SC 3!ANS%)AN3


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Acute ?yeloid )eu"emia

Section 9 @ 1roup 9

?ichelle ?agsalin

Danica ?ae ?iro

Steven Navarro

Kevin Nones

Kristng Santos

Defnition AM# 0 Ac)te Myeloid #e)&emia 0 a res)lt $rom de$ect o$

hematopoietic stem cell that ca)ses )ndi5erentiated blasts o$


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hematopoietic stem cell that ca)ses )ndi5erentiated blasts o$

myeloid in the bone marro%Ca)se ?utation+ C/2%A point mutation(i!ns and (ymptoms ever and in#ection @ result #rom neutropenia

leeding #rom 3hrombocytopenia

(yperplasia o# the gum @ -A?) is more li"ely to in0ltrate so#t tissues.

(epatomegaly

Splenomegaly%riapism -pain#ul engorgement o# the penis.

N)rsin! Inter,ention %revent patient #rom contacting any in#ection < ?onitor CC results especially

neutrophil count+

(and hygiene * proper precaution -such as wearing %%2s* reverse isolation.

when handling the patient*

Anti#ungal * antibacterial -7uinolones. prophylaxis #or severely neutropenic

patients

%alliative care< %ain ?anagement%atients receiving high


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Acute )ymphocytic)eu"emia -A)).

6ro)p 7 38n)o7 and 8n)o94Antes' Antonio' an!eles' arriola' !alap

Man)el' marino' martin' Matias' ,elasco

De0nition Cause and Signs and Nursing interventions/ Diagnostic


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De0nition Cause and!is" actors

Signs andSymptoms

Nursing interventions/?edications

Diagnostic3ests

Acute)ymphocytic

)eu"emia -A)).

< Also calledas acutelymphoblastic

leu"emia< Cancer thatstarts #romthe earlyversion o#white bloodcells calledlymphocytes

in the bonemarrow< It can startin either early cells or 3cells atdi,erentstages o#

maturity< lymphocytesprotect thebody #rominvadinggerms by

maturing intoplasma cells*

3he cause #orA)) isun"nown

(igh numbero# leu"emiacells causes$< %ain in thebones or

6oints< )ac" o#appetite

< Nurse will limitnumber o# visitorsand interruptions byvisitors to providerest periods+

< Nurse will arrangephysical activities toreduce competition#or oxygen supply tovital #unctions* i+e+*avoid activity righta#ter meals+< Nurse will assist

with regular physicalactivities* i+e+*ambulation andtrans#ers+< Nurse willdetermine incollaboration withdietician* number o#calories and type o#nutrients needed tomeet nutritionalre7uirements to planinterventions+< Nurse will monitorrecorded inta"e #or

nutritional contentand calories to

one ?arrow3estone marrowaspirationusing a needle

to remove asample and issent to a lab#or testing toloo" #orleu"emia cells+Imaging 3ests

3o chec" i# A))hasmetastasi'eE


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Acute)ymphocytic)eu"emia -A)).

< Nurse willencourageincreased inta"e o#protein* iron andvitamin C* to

provide nutrientsneeded #ormaximum ironabsorption andhemoglobinproduction< Nurse willprovidein#ormation aboutmedications thatmay inhibit ironabsorption* suchas antacids*

tetracyclineLs* so#tdrin"s* tea* co,ee*calcium*phosphorus andmagnesium salts+< Nurse will reviewwith patient

measurements o#5uid inta"e and


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Acute)ymphocytic)eu"emia -A)).

?edications$< InductionVincristineDexamethasone orprednisoneDoxorubicin -Adriamycin.*Daunorubicin* or a similaranthracycline drug

< CNS treatment orprophylaxis?ethotrexate/Cytarabine/

%rednisone

< ConsolidationSame drugs with theInductionCNS prophylaxis may becontinued

< ?aintenance?ethotrexate and

hematology- anemia

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