Foods to eat Frequent meals Risk for Decreased Cardiac Output Monitor VS Assess

Foods to eat frequent meals risk for decreased

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Foods to eatFrequent mealsRisk for Decreased Cardiac Output- Monitor VS- Assess for pallor, cyanosis, edema- Monitor for anaphylaxis when admin. parenteral ironSelf-Care Deficit- Assist with ADL- Rest periods
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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) cellsLeukemia can develop if significantMDS can be a precursor for leukemia Idiopathic or Primary MDS 70-80% affecting older adults, men slightly higherSecondary MDS 20-30% affecting those exposed to toxins, radiation, benzene, chemo, and aplastic anemias
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Myelodysplastic Syndrome (MDS)DiagnosisCBC, bone marrow biopsy, Serum erythropoietin- kidney function, how well they are working), Vit B12, Folate, Serum Fe, TIBC, FerritinManifestationsAsymptomatic, S/S of anemia, Spleno- & Hepatomegaly, thrombocytopenia, leukopeniaTreatmentBased on severity of disease by several classification systemsGet an erythropoietin stimulating drug: epoitein alfaRoutine monitoring, frequent blood transfusions (which can cause Fe build up: (too much iron cause- endocrine dysfunction, cirrhosis, pericarditis, HF)Desferal for Iron chelation therapyBind to iron and get rid of free flowing ironIron can cause constipation
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Nursing DiagnosesActivity IntoleranceMonitor vital signsEnergy-conservationPrioritizing tasksEncourage sleepSmoking cessationReasons to discontinue activityRisk for Ineffective Health MaintenanceKnowledge of disorderGive support & information
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PolycythemiaErythrocytosis: excess of RBCs, Hematocrit > higher 55%Primary polycythemia (polycythemia vera)Uncommon, affects men European Jewish decent 40-70 ageSecondary polycythemia (erythrocytosis) most commonMost 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 concentrationDehydrated patients Monitor fluid intake and output
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PolycythemiaPrimary: neoplastic stem cell disorder, cause unknown, RBCs produced in the absence of erythropoietinOverproduction 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
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  • Fall '16
  • christiana
  • Hematology, Hemoglobin, Bone marrow

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