Medical-surgical Nursing Demystified

(Sean Pound) #1

(^180) Medical-Surgical Nursing Demystified
INTERPRETING TEST RESULTS



  • Low hemoglobin.

  • Low hematocrit.

  • Low RBC count.

  • Thrombocytopenia—low platelet count.

  • Leukopenia—low WBC.

  • Reticulocyte count low.

  • Positive fecal occult blood test.

  • Decreased cell counts in bone marrow biopsy as body stops producing.


TREATMENT



  • Administer hematopoietic growth factor to correct anemia in patients with
    low erythropoietin levels:

    • erythropoietin, epoetin alfa (recombinant human erythropoietin) by SC
      injection or IV



  • Administer human granulocyte colony-stimulating factor (G-CSF) to correct
    low WBC levels:

    • filgrastim by SC injection or IV

    • granulocyte-macrophage colony-stimulating factor (GM-CSF) sargram-
      ostim by IV infusion



  • Packed RBC transfusions when anemia is symptomatic.

  • Platelet transfusion for severe bleeding.

  • Bone marrow transplant replaces functioning stem cells.

  • Administer immunosuppressive drugs, antithymocyte globulin, and cortico-
    steroids.

  • Splenectomy when spleen is enlarged and destroying RBCs.


NURSING DIAGNOSES



  • Risk for infection

  • Activity intolerance

  • Risk for deficient fluid volume

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