Please enable JavaScript.
Coggle requires JavaScript to display documents.
THERAPIES FOR HEMATOLOGIC DISORDERS (FIBRINOLYTIC (Thrombolytic drugs -…
THERAPIES FOR HEMATOLOGIC DISORDERS
SPLENECTOMY
Surgical removal of spleen, used to tx some hematologic disorders
COMPLICATIONS:
Pancreatic inflammation
Bleeding
Infection
Sepsis
Portal vein thrombosis
Atelectasis
Pneumonia
Subphrenic abscess
Ileus
INDICATIONS:
Hypersplenism
Chronic IDTP
Leukemia
Hemolytic disorders
Sickle Cell Disease
Felty syndrome
PRE OP CARE:
Informed consent
Discuss post op analgesia
NPO 8 hrs prior
Ask for drugs like blood thinners?
Preop assessment and v/s
Administer preop meds
Apply anti embolism stockings
POST OP CARE: - Monitor v/s, heart and lung sounds - Administer meds and maintain IV patency
Reposition pt, and encourage early ambulation
Encourage cough and deep breathing --> splint when coughing
Monitor incision site or drains
Monitor I &Os
Assess complications like bleeding and infection
Obtain specimens for CBC and Plt counts
APHERESIS
Definition
- Procedure where blood is removed from patients body and filtered through centrifuge and specific component such as; platelets, WBC, RBC's, plasma proteins, and circulating stem cells are removed.
Nursing Management
- Flush the access site - Apply a dressing to site - Monitor v/s - Monitor Pt's lab values and report any abnormal results.
Patient Teaching
- Teach Pt about proper venous or arterial access site. - Review the s/s of complications such as infection and instruct to report any abnormal symptoms. - Instruct Pt to avoid individuals with respiratory infections. -Encourage adequate fluid intake. -Teach on the importance of keeping follow-up appt.
THERAPEUTIC PHLEBOTOMY
is a procedure involving the removal of a certain amount of blood under controlled conditions
similar to donating blood
Patients with elevated hematocrits (polycythemia vera) or excessive iron absorption (hemochromatosis) can be managed periodically by removing 1 unit (500mL) of whole blood
Overtime, this procedure can develop iron deficiency
FIBRINOLYTIC
Thrombolytic drugs - used to activate plasminogen to form plasmin, which leads to lysis of thrombi, fibrinogen, and other plasma proteins
Are indicated for thrombolytic disorders, DVT, Peripheral arterial occlusion, MI, and Ischemic Stroke
Complications include bleeding, adverse reactions to other thrombolytic drug, arrhythmia, stroke, embolism
Pretreatment Care- Explain the tx, review pt hx and physical examination to check for any contraindications to medications.
Monitor for allergic reaction , spontaneous bleeding, and oozing from any fresh wound sites.
Dissolve the already formed thrombus formation.
Note that Alteplase is the drug of choice for ischemic stroke and must be used within 3hrs
Contradicted with patients who have had previous hemorrhagic stroke, recent significant head trauma, uncontrolled hypertension, pregnancy, hx of intracranial vessel malformation, known bleeding disorder
COLONY STIMULATING FACTORS
are a group of naturally occurring glycoprotein cytokines that regulate production, differentiation, survival, and activation of hematopoietic cells
Erythropoietin stimulates RBC production (Epogen)
Thrombopoietin plays a key regulatory role in the growth and differentiation of bone marrow cells
Interleukin 5 (IL-5) stimulates the growth and survival of eosinophils and basophils. Stem cell factor and IL-3 serve as stimuli for multiple hematopoietic cell lines
Granulocyte colony-stimulating factor, granulocyte-macrophage colony-stimulating factor, and macrophage colony-stimulating factor all serve as growth factors for specific cell lines. (Filgrastim/Neupogen)
STEM CELL TRANSPLANTATION
(SCT) also referred to as bone marrow transplant Is a procedure in which a pt receives healthy stem cells to replace damaged stem cells. Explain procedure, pt will receive chemo and radiation before transplantation. Informed consent, maintain asepsis, infection control precautions, discuss immunosuppressants, Monitor v/s every 15 min