CBC Practice A &B: Level III Latest Update Graded A

CBC Practice A &B: Level III Latest Update Graded A Thrombocytopenia Low blood platelet count. NURSING CONSIDERATIONS ◯Monitor PLATELET count. ◯Monitor for petechiae, ecchymosis, bleeding of the gums, nosebleeds, and occult or frank blood in stools, urine, or vomitus -every 4 hours! ◯Institute bleeding precautions. ■Avoid IVs and injections. ■Apply pressure for approximately 10 min after blood is obtained. ■Handle client gently, place on fall precautions, and avoid trauma. ◯Administer thrombopoietic medications such as oprelvekin to stimulate platelet production. Monitor platelet count, and be prepared to administer platelets if the count falls below 10,000/mm3. CLIENT EDUCATION ●Instruct the client and family how to manage active bleeding. ●Instruct the client about measures to prevent bleeding (use electric razor and soft‐bristled toothbrush, avoid blowing nose vigorously, ensure that dentures fit appropriately). ●Instruct the client to avoid the use of NSAIDs. ●Teach the client to prevent injury when ambulating (wear closed‐toes shoes, remove tripping hazards in the home) and apply cold if injury occurs Anemia NURSING CONSIDERATIONS ◯Monitor for fatigue, pallor, dizziness, and shortness of breath. ◯Help the client manage anemia‐related fatigue by scheduling activities with rest periods in between and using energy saving measures (resting elbows on table and sitting during showers and other ADLs). ◯Administer erythropoietic medications (e.g.,darbepoetin alfa, Epoetin Alfa) and antianemic medications (e.g., ferrous sulfate) as prescribed. ◯Monitor Hgb values to determine response to medications. Be prepared to administer blood if prescribe PT EDUCATION ◯report a SEVERE HEADACHE to the child's provider because it can be an indication of a stroke. ◯apply warm compresses to the affected joints to prevent vasoconstriction. ◯encourage the child to increase fluid intake to maintain hydration. Sickle Cell Anemia autosomol recessive genetic disorder. defective/malformed RBCs S/S: -severe pain -SOB -fatigue -pallor -jaundice CRISIS LABS -increased WBC and bilirubin -decreased Hgb 1st STAGE Vaso-oclusive crisis (painful episode) S/S: *-hematuria (from ischemia to the kidneys) -jaundice -severe painful in hands, feet, abd, joints, and bones -swelling of the hands, feet, and joints -vision changes 2ND STAGE Sequestration S/S: -enlarged spleen and liver -hypovolemia and at r/f hypovolemic shock 3RD STAGE Aplastic crisis -severe anemia trigguered by infection/virus