Question

163 Disarders of the Hematopoietic System CHAPTER 31 Caring for Clients With Activity F Anwer the , What prohlems clients eaed to earing for clients with disonders of the hematopoietic system have? do clients with sickle cell disease have? 5. What are the signs and symptoms yteia ves? 工what is the 6. What is the medical treatment for multiple mycloma? 1 What is the treatment for polycythemia vera? 7. What are the signs and symptoms of aplastic anemia? is leukemia medically managed? & What is the medical treatment for thrombocytopenia? ctivity G Think over the Jollowing questions. Discuss them with your instructor or peers. L. Your client is diagnosed with sickle cell disease. What What general nursing assessments and interventions will educational information will you provide to this client? you provide to all clients diagnosed with anemia? 2 Your client is diagnosed with acute lymphocytic leuke- 4. What nursing assessments and interventions will you mia. His absolute neutrophil count indicates that he is at provide to clients that are specific to each type of the high risk for infection. You place the client in neutropeseven nie precautions. What guidelines will you follow?

Answer 1

2 .Pathophysiology of polycythemia vera:

Polycythemia veta is a proliferative disorder in myeloid stem cells . The bone marrow cells are hypercellularized leading to elevated count of RBC, WBC and platelets in peripheral blood. This RBC elevation is predominant in polycythemia vera. If this continues for an extended time even years that gives more work to the spleen so it enlarge and bone marrow cells becomes fibrotic . Due to enlarged spleen and defective bone marrow RBC production proceed independently of erythropoietin.  Isolated erythrocytosis may occur due to secondary erythrocytosis which may be due to neoplasms . The neoplasms may stimulate erythropoietin production . Large number of RBC make blood thick leading to thrombosis resulting in CVA, heart attack and also bleeding complications occur. This disease sometimes evolves as myelofibrosis or acute myeloid leukemia.

3.The treatment for polycythemia vera is

• Phelobotomy which involves removing of enough blood to deplete the iron stores to make patient iron deficient which may control the production of RBC for sometime.
• Aspirin therapy to prevent clots
• Chemotherapeutic agents to supress the bone marrow function.

4. Leukemia is a neoplastic proliferation of any white blood cell type ( granulocyctes, monocytes, lymphocytes, or megakaryocytes). Leukemia is medically managed by induction therapy by administering chemotherapeutic agents in large doses. Supportive therapy with transfusion of blood products and treatment of any bacterial, viral, fungal infections due to severe neutropenia.

5. Mutiple myeloma is a malignant disease of most matured form of B lymphocyte which is a plasma cell secreting immunoglobulins.

Signs and symptoms of mutiple myeloma are

• Bone pain, especially in your back and ribs
• Elevated pain during movements
• Nausea
• Anorexia
• Confusion
• Dehydration
• Fatigue
• Recurrent infections
• Weight loss
• Weakness or numbness in your legs
• Excessive thirst
• Fractures
• Coma

6. Mutiple myeloma is a malignant disease of most matured form of B lymphocyte which is a plasma cell secreting immunoglobulins. Actually there is no cure for multiple myeloma. Chemotherapy is a primary treatment and corticosteroids are also used. Targeted drug treatment aims to  block the action of the cancer substance in myeloma cells that breaks down proteins.  

7. Aplastic anemia is caused by a decrease in stem cells of bone marrow leading to decreased or cessation of production of blood cells.

Signs and symptoms include

• Fatigue
• Pallor
• Dyspnea
• Dizziness
• Headache
• Irritability
• Purpura
• Alteration in heart beat sometimes irregular and tachycardiac.

8. Thrombocytopenia is characterized by low platelet level.

Medical management include

• Treatment of underlying cause(any condition leading to destruction of platelets or increased consumption of platelets)
• Infusion of platelets
• Corticosteroids.