Med surg exam 2 study guide

Med surg exam 2 study guideChapter 29/30  WBC-know your ranges o 5,000-10,000  RBC-know your labs o 4.2-6.1 million  H/H know your labs o Hemoglobin- 12-18 o Hematocrit- 37%-52%  Neutropenic Precautions- several questions on this o Wash hands frequently o Reverse Isolation o Avoid raw and uncooked meats and eggs and soft cheeses with molds o HEPA environment o No pets  Non-Hodgkin’s Lymphoma (signs/symptoms) complications o cancer that originates in your lymphatic system, the disease fighting network spreads throughout the body. o tumor develops from lymphocytes- a type of white blood cells. o Signs/Symptoms  Painless swollen lymph nodes in neck, armpits  Abdominal pain, coughing or trouble breathing  Persistent fatigue  Fever  Night sweats  Unexplained weight loss  Superior Vena Cava Syndrome-what is this and why does it occur? o Results from obstruction of superior vena cava by tumor or thrombosis o Common causes are lung cancer, non-Hodgkin’s lymphoma, metastatic breast cancer o Presence of central venous catheter and previous mediastinal radiation increase risk o Manifestations (S&S)  Facial edema, periorbital edema  Distention of veins of head, neck, and chest  Headache, seizures  Mediastinal mass on chest x-ray o Management  Considered a serious medical problem  Radiation therapy to site of obstruction  Chemotherapy for tumors more sensitive to this therapy  Anemia: signs and symptoms- how does this affect everyday life? o Signs & Symptoms  Fatigue Downloaded by DANIEL NDAMBIRI () lOMoARcPSD| A++  Dizziness  Fainting  Paleness  Coldness  Low blood pressure  Palpations  Rapid heart rate  Shortness of breath  Yellowing (eyes and skin) o Affects everyday life, by the heart must work harder to make up for lack of red blood cells or hemoglobin, Pt become fatigue, breathless, constant headache, it effects mental health and matters of the heart  Signs of fluid volume deficit/dehydration o Thirst o Irritability o Dry mucous membranes o Dizziness o Coma o Seizures o Sunken eyeballs o Poor skin turgor o Increased HR o Decreased BP  What medications are contraindicated for those with tendency for bleeding? o Aspirin o Salicylate o Acetylcholine  Thrombocytopenia- diagnosis, treatment, and causes, teaching related to o Diagnosis  Platelet count  Hgb/Hct  CBC  Bone marrow aspiration o Treatment  Bleeding precautions (no straight razor/ soft toothbrush)  Platelet transfusions  Avoid aspirin or other anticoagulants  Avoid heparin if heparin-induced o Causes  Decreased bon marrow production (inherited or acquired)  Increased platelet destruction  Sequestering of platelets (usually by the spleen)  Heparin-induced Downloaded by DANIEL NDAMBIRI () lOMoARcPSD| A++  Thrombotic thrombocytopenic purpura o Patient Teaching  Notify your HCP of any symptoms of bleeding  Ask about restrictions in your normal activities  Do not blow your nose forcefully  Do not bend down with your head lower than your waist  Prevent constipation by drinking plenty of fluids  Shave only with an electric razor  Do not puncture your skin  Do not use any medications that can prolong bleeding  Use a soft-bristle toothbrush to prevent injuring gums  Women who are menstruating should keep track the number of pads that are used daily.  Ask your HCP before having any invasive procedures  Polycythemia Vera-diagnosis, treatment, and causes o A condition that results in an increased level of circulating red blood cells in the bloodstream o Diagnosis  An H/H (hematocrit and hemoglobin) blood test  RBC count  Medical history and physical examination  Hemoglobin level 18.65 in men and 16.5 in women  Bone marrow evidence of increased red blood cell production and decreased EPO levels