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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 –