Subjective Data Case Study, Leukemia • Progressive we • Has had a rece • Reports perio • Has noticed a Objective Physica

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Subjective Data Case Study, Leukemia • Progressive we • Has had a rece • Reports perio • Has noticed a Objective Physical Ex Patient Profile A.J. is a 63-yr-old white woman who is brought to the ED by her husband (see the Chapter 29 case study). has become progressively weaker and was admitted for further evaluation. She • Has scatte . Her skin • BP 100/ pulse 11
Subjective Data - Progressive weakness over the last couple of weeks - Has had a recent sinus infection that resolved after 2 courses of antibiotics - Reports periodic shortness of breath • Has noticed a lot of bruising lately. Objective Data Physical Examination • Has scattered petechiae on both ankles and 2 ecchymoses on her arms and 3 on her left lower leg . Her skin is very pale - BP 100/70 (lying), 88/60 (standing), temperature 96.8°F (36°C), respiratory rate 26/min, apical pulse 110/min (lying). 124/min (standing). O2 saturation 90% on room air
Laboratory Results • Hct 18.2%. Hgb 5.9 g/dL, WBC count 2600/L (2.6 x 109/L). Platelet count 72,000/uL (72 10 9 /L) . Peripheral blood smear shows that 80% of the WBCs are blasts . PT 18 sec, aPTT 37 sec LDH 560 units/L 1. What co suggest Bone Marrow Biopsy 2. How is ac • Multiple myeloblasts (>50%) 3. What is A Interprofessional Care 4. What are and treatm 5. Priority nursing dia Consultation with a hematologist-oncologist . 2 units of packed red blood cells Diagnosis: acute myelogenous leukemia .
Discussion Questions 2 x 10 9 • LDH 1. What components of the laboratory test results and bone marrow biopsy suggest acute leukemia? 2. How is acute myelogenous leukemia treated? 3. What is AJ.'s prognosis? 4. What are the life-threatening problems that can occur because of this disease and treatment? How can you anticipate and assess for these problems? 5. Priority Decision: Based on the assessment data presented, what are the priority nursing diagnoses? Are there any collaborative problems?
Discussion Questions 6. Priority Decision: What are the priority nursing interventions for AJ.? 7. Patient-Centered Care: What are the priorities for patient teaching with a newly diagnosed adult with leukemia? 8. Collaboration: What members of the interprofessional team are likely to be involved in AJ!'s care? 9. Evidence-Based Practice: AJ. becomes fatigued after starting chemotherapy. She wants to know if she can still work and do household chores even if she is so fatigued. What is your best advice for her? 10. Develop a conceptual care map for AJ.