Med Surg 2 Exam 2 Part 2

• Aplastic Anemia


  Condition with pancytopenia (low blood cell counts)
• Aplastic Anemia symptoms


  • Fever
  • Infection
  • Bleeding
  • Anemia symptoms
• Aplastic Anemia Diagnostic

  Bone marrow biopsy
• Aplastic Anemia Risk factors

  Chemo, Sulfas, methotrexate, Phenytoin
• Polycythemia Vera


  Bone marrow disorder
• Polycythemia VeraRisk factors

  Gene mutation, occurs after birth
• Polycythemia Vera affects males and females
• Polycythemia Vera symptoms


  • Increased red blood cells, white blood cells, platelets
  • Hyperviscous blood
  • Impaired circulation
  • Hypoxemia
  • Impaired perfusion
  • Shortness of breath, headache, vision problems, dizziness, weakness
  • Pruritus (itching after hot bath)
• Polycythemia Vera Diagnostic

  CBC, increased red blood cells, white blood cells, hemoglobin/hematocrit, platelets
• Polycythemia Vera treatment

  • Phlebotomy
  • Aspirin
  • Hydroxyurea
  • Interferon
  • Radiation
• Polycythemia Vera Nursing care

  Monitor CBC, watch for complications like clots, stroke, heart attack, bleeding
• Thrombocytopenia

  Low platelet count
• Thrombocytopenia causes

  • Immunosuppressants
  • Liver disease (hepatitis, cirrhosis)
  • ITP (immune thrombocytopenic purpura)
  • TTP (thrombotic thrombocytopenic purpura)
  • HIT (heparin-induced thrombocytopenia)
• Thrombocytopenia symptoms


  • Bleeding gums
  • Tachycardia, hypertension, dizziness
  • Petechiae (tiny red/purple spots)
  • Ecchymosis (bruising)
• Thrombocytopenia treatment

  • Hold platelets
  • Heparin
  • Aspirin
  • Steroids
  • Immune therapy
  • Clopidogrel
  • Platelet transfusion
  • Splenectomy
• Thrombocytopenia Nursing care

  Avoid razors, enoxaparin
• Platelet count below 150,000 is major risk, below 50,000 is deadly
• ITP (immune thrombocytopenic purpura)


  Autoimmune condition with shortened platelet lifespan
• TTP (thrombotic thrombocytopenic purpura)


  Condition with abnormal platelet clumping and clotting
• HIT (heparin-induced thrombocytopenia)


  Immune response to heparin causing both venous and arterial clots
• HIT treatment

  • Argatroban
  • Thrombolytics
• Avoid NSAIDs in thrombocytopenia
• Thrombocytopenia Diagnostic

  Platelet count, specific studies, bone marrow for ITP
• Lymphoma


  Malignant disorder of lymphocytes
• Lymphoma types

  • Hodgkin's lymphoma
  • Non-Hodgkin's lymphoma
• Lymphoma risk factors

  • Down syndrome
  • Smoking
  • Radiation
  • Benzene
• Lymphoma symptoms


  • Painless, fever
  • Swollen lymph nodes
  • Increased infections
  • Anemia
  • Bleeding
• Diagnostic

  CBC, lymph node biopsy, MRI
• Non-Hodgkin's lymphoma risk factors

  • Immunodeficiency
  • EBV, HIV, hepatitis B/C
  • Carcinogens
• Lymphoma consequences

  • Anemia
  • Neutropenia, increased infections
  • Thrombocytopenia, bleeding
• Lymphoma treatment

  • Chemotherapy
  • Bone marrow transplant
• Lymphoma Nursing care

  Monitor for anemia, thrombocytopenia, labs
• Multiple Myeloma


  Malignancy of B lymphocytes
• Multiple Myeloma symptoms


  • Back/bone pain
  • Diffuse osteoporosis
  • Pathologic fractures
  • Hypercalcemia
  • Renal failure
• Multiple Myeloma treatment


  • Bisphosphonates
  • Chemotherapy
  • Corticosteroids
  • Immunomodulators
• Multiple Myeloma Nursing care

  Risk of fractures, pain management, hydration, education, facilitate advanced directives
• Renal Cell Carcinoma


  Kidney cancer
• Renal Cell Carcinoma risk factors

  • Tobacco use
  • Family history
  • Obesity
  • Hypertension
  • Exposure to asbestos, herbicides, gasoline, diuretics
• Renal Cell Carcinoma symptoms

  • Flank mass
  • Hypertension
  • Flank pain
  • Fever
  • Anemia
  • Hematuria
  • Weight loss
  • Fatigue
• Renal Cell Carcinoma Diagnostic

  Ultrasound, CT, MRI, angiogram, biopsy, radionuclide scan, urine cytology