Question

Make up a patient scenario, include assessment data and nursing diagnoses.

Answer 1

Patient scenario :-

A 5year boy came to the hospital with complaints of fever, weakness , less appetite × 20 days. On examination , abdominal distension , hepatomegaly and splenomegaly were present . His CBC count from outside was Hb - 7.8gm/dl, platelets - 46000, WBC - 67000 . Peripheral smear showed 40% blasts

Suspected -Acute leukemia

For the diagnosis :- Investigation including :-

CBC

LFT/RFT

Peripheral blood PS

Viral marker

LDH

Bone marrow aspiration - PS

Bone marrow flowcytometry

Bone marrow PCR panel

FISH

Cytogenetics were done and it was found that he was having B - ALL .

Treatment was started with steroids and chemotherapy .

Nursing diagnosis :-

1. Risk for infection related immunocompromised

2. Risk for impaired skin integrity related to side effects of chemotherapy

3. Impaired mucous membrane due to chemotherapy

4. Imbalanced nutrition less than body requirements related to hypermetabolism state , anorexia , mucositis , pain and nausea

5. Hyperthermia related to tumor lysis and infection

6. Acute pain and discomfort related to mucositis ,leukocytosis infiltration of systemic tissues ,fever, and infection

7. Fatigue related to anemia and infection