Medical Surgical Nursing

1. Monitor RBC count, hemoglobin,

and hematocrit levels as indicated.

2. Administer medications as

prescribed, including iron and folic

acid supplements, Epogen, and

multivitamins.

3. Avoid drawing unnecessary blood

specimens.

4. Teach patient to prevent bleeding:

avoid vigorous nose blowing and

contact sports, and use a soft

toothbrush.

5. Administer blood component

therapy as indicated.

1. Provides assessment of

degree of anemia.

2. RBCs need iron, folic

acid, and vitamins to be

produced. Epogen

stimulates the bone

marrow to produce

RBC.

3. Anemia is worsened by

drawing numerous

specimens.

4. Bleeding from

anywhere in the body

worsens anemia.

5. Blood component

therapy may be needed

if the patient has

symptoms.

 Patient has a

normal skin

color without

pallor

 Exhibits

hematology

values within

acceptable limits

 Experiences no

bleeding from

any site

Bone Disease and Metastatic Calcifications

1. Administer the following
   medications as prescribed:
   phosphate binders, calcium
   supplements, vitamin D
   supplements.


2. Monitor serum lab values as
   indicated (calcium, phosphorus,
   aluminum levels) and report
   abnormal findings to physician.


3. Assist patient with an exercise
   program.

1. Chronic renal failure

causes numerous

physiologic changes

affecting calcium,

phosphorus, and

vitamin D metabolism.

2. Hyperphosphatemia,

hypocalcemia, and

excess aluminum

accumulation are

common in chronic

renal failure.

3. Bone demineralization

increases with

immobility.

 Exhibits serum

calcium,

phosphorus, and

aluminum levels

within

acceptable

ranges

 Exhibits no

symptoms of

hypocalcemia

 Has no bone

demineralization

on bone scan

 Discusses

importance of

maintaining

activity level and

exercise program