Foods to eat frequent meals risk for decreased

Foods to eat
– Frequent meals
•
Risk for Decreased Cardiac Output
-
Monitor VS
- Assess for pallor, cyanosis, edema
- Monitor for anaphylaxis when admin.
parenteral iron
• Self-Care Deficit
-
Assist with ADL
- Rest periods

Myelodysplastic Syndrome (MDS)
•
Abnormal dysfunctional bone marrow and cytopenia low
circulating blood cells
–
Stem cell disorder fail to reproduce/differentiate into various
types of RBCs , genetic components are altered nuclear
DNA/mitochondrial DNA , bone marrow makes abnormal
(dysplastic) cells
–
Leukemia can develop if significant
•
MDS can be a precursor for leukemia
•
Idiopathic or Primary MDS 70-80% affecting older adults,
men slightly higher
•
Secondary MDS 20-30% affecting those exposed to toxins,
radiation, benzene, chemo, and aplastic anemias

Myelodysplastic Syndrome (MDS)
•
Diagnosis
–
CBC, bone marrow biopsy, Serum erythropoietin- kidney function, how well
they are working) , Vit B12, Folate, Serum Fe, TIBC, Ferritin
•
Manifestations
– Asymptomatic, S/S of anemia, Spleno- & Hepatomegaly, thrombocytopenia,
leukopenia
•
Treatment
–
Based on severity of disease by several classification systems
•
Get an erythropoietin stimulating drug: epoitein alfa
–
Routine monitoring, frequent blood transfusions (which can cause Fe build up:
( too much iron cause - endocrine dysfunction, cirrhosis, pericarditis, HF)
–
Desferal for Iron chelation therapy
• Bind to iron and get rid of free flowing iron
• Iron can cause constipation

Nursing Diagnoses
•
Activity Intolerance
–
Monitor vital signs
–
Energy-conservation
–
Prioritizing tasks
–
Encourage sleep
–
Smoking cessation
–
Reasons to discontinue activity
•
Risk for Ineffective Health Maintenance
–
Knowledge of disorder
–
Give support & information

Polycythemia
•
Erythrocytosis: excess of RBCs, Hematocrit > higher 55%
–
Primary polycythemia (polycythemia vera)
•
Uncommon, affects men European Jewish decent 40-70 age
–
Secondary polycythemia (erythrocytosis) most common
•
Most common, Erythropoietin levels inc., develops as a response to
hypoxia (smoking, high altitude, chronic lung dz)
–
Relative polycythemia
•
Due to fluid deficit (inc. cell concentration)
•
Same amount of solute but took solvent away so cause higher
concentration
•
Dehydrated patients
•
Monitor fluid intake and output

Polycythemia
•
Primary: neoplastic stem cell disorder, cause unknown, RBCs
produced in the absence of erythropoietin
–
Overproduction of RBCs, Low WBCs/platelets
–
Manifestations: asymptomatic, but increases blood volume and
viscosity = HTN, Headache, dizziness, venous stasis (plethora – ruddy,
red color) severe painful itching of digits, Hypermetabolism (wt loss,
night sweats), (altered mental status) drowsiness, delirium, thrombosis
& hemorrhage
–
not the focus, focus basically what is it
•
Secondary: Response to excess erythropoietin (kidney dz, renal
cell carcinoma) or prolonged hypoxia (high altitudes, smoking,
lung/ heart dz)
–
Increase RBCs in response to increase erythropoietin or prolonged
hypoxia
–