COA Exam 4
treatment for ganglions
-asymptomatic ganglions are monitored, since approximately 50% will resolve without treatment -other treatments may include aspiration, corticosteroid injection, surgical excision -after treatment, compression dressing and immobilization splint are used
nursing intervention after giving platelets
-check temperature -identify symptoms of rash, SOB, chills, fever, vomiting, headache
physical exam findings for IDA
-circumoral pallor -conjunctival pallor -brittle nails -angular cheilitis -tachycardia -hypotension -murmurs
which conditions should be considered if patient has hemoconcentration
-dehydration *BURNS -shock -hypothermia
what are the three primary cell types
-erythropcytes -leuokocytes -thrombocytes
cues for IDA
-fatigue -dizziness -pica -lightheadedness -palpitations
what are the symptoms of H&H
-fatigue -dyspnea -palpitations -poor activity tolerance -headaches -tinnitus -anorexia -indigestion -irritability -difficulty sleeping or concentration -abnormal menstruation -impotence -loss of libido -chest pain
signs and symptoms of Acute Myeloid Leukemia
-fever -infection -neutropenia -enlarged spleen -gum hyperplasia
complications of anemia
-heart failure -parasthesias -confusion
priority nursing interventions for AML
-infection prevention -bleeding prevention -promoting comfort -patient education
labs to look at for IDA
-iron -ferritin -iron saturation -increased TIBC (always opposite of iron)
what will assessment of a patient with osteomyelitis reveal?
-localized pain -edema -erythema -fever -guarding -purulent drainage
nursing management of anemia
-managing fatigue -promoting nutrition (iron, B12, folic acid, avoid alcohol) -educating patient on underlying cause of anemia -maintaining perfusion (transfusion of IV, supplemental O2, monitor vitals)
goals and interventions for osteomyelitis
-pain -improved physical ability and therapeutic limitations -control and eradication of infection -knowledge of the treatment regimen
who is at risk for developing carpal tunnel syndrome
-patients who have to perform repetitive movements or those whose hands are exposed repeatedly to cold temperature, vibrations, or extreme direct pressure
symptoms of bleeding
-petechiae -eccyhmosis -bleeding at puncture site -*hypotension -tachycardia -dizziness -nosebleed -*hemoptysis -*abdominal pain or back pain -*abdominal distention -rectal bleeding -vaginal bleeding -*headache -*mental status change -*blurred vision
nursing priorities for acute lymphoid luekemia
-prevention of infection and bleeding -management of symptoms such as nausea and pain
if patient is experiencing the following symptoms after getting a platelet infusion (rash, SOB, chills, fever, vomiting, headache) ...
1) stop infusion 2) lift head of bed
how much calcium do premenopausal women require daily
1,000 mg
recommended calcium intake age 19-50
1,000 mg
recommended daily calcium intake for people 9 to 19 years of age
1,300 mg/day
how much calcium do postmenopausal women require
1,500 mg
mild neutropenia
1,500 to 1,000/mm3
conservative treatment of bursitis and tendonitis
1. Rest of the extremity 2. Intermittent ice and heat to the joint 3. NSAIDS - to control the inflammation and pain] corticosteroid injections may be injected
normal hemoglobin FAB
12-16 g/dL
lifespan of RBC
120 days
normal hemoglobin MAB
14-18 g/dL
normal plaetelet count
150 - 400,000/mm3
normal platelet FAB
37%-47%
normal hematocrit MAB
40%-52%
lifespan of platetelet/thrombocyte
7-10 days
moderate neutropenia
999-500/mm3
at what platelet count would the patient be placed on bleeding precautions?
< 500,000/mm3
which disease renders the fingers more or less useless
Dupuytren
which medications would be given to someone with anemia of kidney disease?
ESA (erythropoietin stimulating agents) Epogen; Darbepoeitin
foods high in iron
Meats, eggs, legumes, whole grains, green leafy vegetables , and dried fruits
treatment for paget disease
NSAIDs, calcitonin, bisphosphonates
A nurse is caring for a client with iron deficiency anemia. Which food or beverage will the nurse suggest to the client to eat or drink when taking supplemental iron? When they should take their iron?
Orange juice because vitamin C increased absorption of iron they should take their iron on an empty stomach in the morning
whats a weird symptom that can develop from iron deficiency anemia?
PICA
which tests might be used to identify carpal tunnel syndrome
Phalen test or Tinel sign
A nurse is performing discharge teaching for an elderly client with osteoporosis. Which instruction about a calcium supplement should the nurse include?
Take the supplement with meals or with orange juice.
osteomyelitis stage 1
acute fulminating: occurring during the first 3 months after orthopedic surgery; frequently associated with hematoma, drainage, or superficial infection
treatment of osteomyelitis
antibiotics, surgical debridement
complications of acute myeloid leukemia (AML)
bleeding and infection
therapeutic apheresis
blood is taken from the patient and passed through a centrifuge to remove a specific component
primary site of hemoatopoiesis
bone marrow
most common presenting symptom in multiple myeloma
bone pain
hallux vagus
bunion deformity in which the great toe deviates laterally
which nutrients are key for maintaining bone remodeling and body function
calcium and vitamin D
osteomyelitis stage 2
delayed onset: occurring between 4 and 24 months after surgery
pathophysiology of IDA
depletion of the body's iron stores
paget disease
disorder of localized rapid bone turnover, most commonly affecting the skull, femur, tibia, pelvic bones, and vertebrae
action for IDA
education of food/dietary considerations, manage side effects of iron (constipation)
how often should PT and INR be checked if pt is on a heparin drip
every 6 hours
how often should type-and-draw occur after blood transfusion?
every 72 hours
what lab signs might you see for hemodilution
false low hematocrit (seen in CHF patients, symptoms would normalize with management of CHF)
what lab signs would you see for hemoconcentration
falsely elevated hematocrit
what is a good source of vitamin B12 for vegans?
fortified soy milk for vegans
primary component of RBCs
hemoglobin
nursing priorities for osteoporosis
improving bowel function, preventing injury, and managing fractures
where do bursitis and tendonitis most commonly occur?
in the shoulder
which therapy is indicated for acute lymphoid luekemia?
induction therapy
osteomyelitis
infection of the bone, usually staphylococcus aureus
solutions for iron deficiency anemia
iron PO prefered over IV
anemia of kidney disease presents very similarly to what other kind of anemia?
iron deficiency anemia
recommended daily calcium intake for people 51 years of age and older
is 1,200 mg/day
osteomyelitis stage 3
late onset: occurring 2 or more years after surgery, usually as a result of hematogenous spread
foods high in folic acid
leafy greens, dried peas, dried beans, seeds, orange juice
severe neutropenia
less than 500 mm3
an elderly patient whose chief complain is back pain and who has an elevated total protein level should be evaluated for which condition?
myeloma
treatment for multiple myeloma
no cure corticosteroids and chemotherapy
foods high in Vitamin B12
organ meats (liver) , clams, oysters, red snapper, muscle meats, fermented cheese, egg yolks, dairy
symptoms of carpal tunnel syndrome
pain, numbness, paresthesia, possibly weakness along median nerve
what is the treatment for metastatic bone cancer?
palliative
what is the most common sign of H&H?
pallor
who is likely to experience vitamin B12 deficiency?
patients who have gotten a partial or total gastrectomy
Hematocrit
percentage of blood volume consisting of erythrocytes
function of granulocytes
protect the body from invasion by bacteria or foreign body
therapeutic phlebotomy
removal of a certain amount of blood under controlled conditions
how does AML occur
results from a defect in the hematopoietic stem cell that differentiates into all myeloid cells
how does acute lymphoid leukemia occur?
results from an uncontrolled proliferation of immature cells (lymphoblasts) derived from the lymphoid stem cell
important nursing intervention for iron deficiency in older adults
should be investigated quickly for GI tract of colon CA
assesment of osteoporosis will reveal what
skeletal changes and bone density
osteomalacia
softening of the bone
hemoatopoiesis
the process of replenishing blood cells
special iron consideration for menstruating people
they need an additional 2 mg/day to replace iron lost by menstruation