Question

11:50 a no 91% X Case Study. Chap... 9 zoleuronic acid (zometa), calidomide (Thalomid), allopurinol (Zyloprim), calcitonin, ibuprofen, and Vicodin. (Learning Objective 5) a. What nursing management should the nurse provide the patient? b. Explain the indication and action of the various medications ordered to treat the patient's symptoms. 2. Susan Clare, age 38, is admitted to the medical oncology unit with acute myeloid leukemia (AML). She has many areas of ecchymosis and petechiae on her skin, as well as generalized pallor. She states she has lost 15 pounds in the last 2 months, and often has a low-grade fever. On physical assessment, you find her liver and spleen to be enlarged on palpation. (Learning Objective 3) a. What laboratory results would you anticipate due to her ecchymosis and petechia? b. Why would it be important to inspect her gums and teeth? c. Why is her liver enlarged?

Answer 1

ANS 2 - (a) Laboratory results that may be attribued to Ecchymosis and Petechiae are -

The laboratory tests includes Complete blood count and a peripheral blood smear.

Individuals develop small red or purples spots on the skin called petechiae that are caused by bleeding under the skin, or larger, purple spots called ecchymosis caused by bleeding from ruptured blood vessels under the skin.

Petechiae are attributable to platelet or vascular abnormalities; if systemic symptoms are present and the petechiae are tender and elevated, vasculitis should be suspected.

ANS 2 - (b) It is important to assess the gums and teeth as inflammation of tissue in the mouth can cause swollen, bleeding gums, sores and be painful due to Thrombocytopenia.

ANS 2 - (c) The enlargement of liver and spleen is called hepatosplenomegaly. The clinical presentation of acute leukemia results from infiltration of bone marrow or extramedullary sites by blasts. When blasts infiltrate organs it results in hepatosplenomegaly.