Ms. Y is a 44-year-old woman diagnosed with non-Hodgkin lymphoma… Ms. Y is a 44-year-old
Ms. Y is a 44-year-old woman diagnosed with non-Hodgkin lymphoma… Ms. Y is a 44-year-old woman diagnosed with non-Hodgkin lymphoma (NHL) 3 months ago. She finished receiving her third of six chemotherapy courses 5 days ago. Yesterday morning, she was seen at her oncologist’s office for malaise, muscle weakness, and palpitations. She had splenomegaly on examination. A computed tomography (CT) scan of the abdomen showed metastatic disease in the liver and spleen. She is admitted to the hospital with progressive weakness.Name 3 risk factors for lymphoma.A.B.C.Chart ViewComprehensive Metabolic Panel (CMP) Na 139 mEq/LK 6.3 mEq/LCl 96 mEq/LCO2 28 mEq/LGlucose 101 mg/dLBlood urea nitrogen (BUN) 59 mg/dLCreatinine 2.5 mg/dLCa 6.9 mg/dLTotal protein 5.4 g/dLAlbumin 2.8 g/dLPhosphorus 4.9 mg/dLUric Acid 21 mg/dLTotal bilirubin 0.8 mg/dLAlkaline phosphatase 172 units/LAspartate transaminase (AST) 254 units/LAlanine transaminase (ALT) 74 units/LLactate dehydrogenase (LDH) 214 IU/L Interpret Ms. Y’s admitting comprehensive metabolic panel results. Based on the laboratory test results, which common oncologic emergency is Ms. Y experiencing? Describe the pathophysiology of this condition. What assessment findings related to this diagnosis would you expect in Ms. Y? Complete Blood Count (CBC) White blood cells (WBCs) 1500/mm3Neutrophils 66% Lymphocytes 16 %Monocytes 15%Eosinophils 5%Hemoglobin (Hgb) 7.9 g/dLHematocrit (Hct) 22.4%Platelets 21,000/mm3 Interpret the lab values above. Name 3 additional problems for which Ms. Y is at risk. What are your nursing priorities right now and why? Medication Record IV 0.9% normal saline at 150 mL/hr 100 mEq sodium bicarbonate (NaHCO3) in the first liter of the IV fluid rasburicase 6 mg IV now allopurinol 500 mg twice a day orally furosemide 40 mg IVP now then every 6 hours sodium polystyrene sulfonate (Kayexalate) 15 g orally every 6 hours aluminum hydroxide 2 caps orally with meals What is the expected outcome associated with each medication Ms. Y is receiving?normal salineNaHCO3rasburicaseallopurinolfurosemideKayexalate What are your nursing responsibilities when administering Kayexalate? Discuss 2 major complications that could happen if Ms. Y’s abnormal laboratory test results (CMP results) will not be resolve?A.B. Name 3 signs and symptoms for each of the following problems.A. anemiaB. neutropeniaC. thrombocytopenia List at least 7 independent nursing interventions that you would include based on the client’s abnormal laboratory test results.A.B.C.D.E.F.G.Comprehensive Metabolic Panel (CMP) day 2 Na 136 mEq/LK 4.7 mEq/LCl 104 mEq/LCO2 26 mEq/LGlucose 110 mg/dLBlood urea nitrogen (BUN) 36 mg/dLCreatinine 2.1 mg/dLCa 7.9 units/LTotal protein 5.4 g/dLAlbumin 2.8 g/dLPhosphorus 4.1 mg/dLUric Acid 2.0 mg/dLTotal bilirubin 1.0 mg/dLAlkaline phosphatase 94 units/LAspartate transaminase (AST) 46 units/LAlanine transaminase (ALT) 44 units/LLactate dehydrogenase (LDH) 222 IU/L Interpret Ms. Y’s latest lab results by comparing it with the previous laboratory test results 24 hours ago. If you think that the client’s condition is resolving, what other interventions would you include in her plan of care? List at least 5 other oncologic emergencies and give at least two nursing interventions for each.A.B.C.D.E. Health Science Science Nursing NUR 450 Share QuestionEmailCopy link Comments (0)
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