By Hilarie Surrena
This concise medical spouse to the 12th variation of Brunner and Suddarth's Textbook of Medical-Surgical Nursing offers approximately two hundred ailments and issues in alphabetical structure, permitting swift entry to need-to-know details at the most typically scientific difficulties nurses are inclined to come across. The content material is totally cross-referenced to the most textual content. Pages are tabbed alphabetically for quick reference.
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Extra resources for Handbook for Brunner and Suddarth's Textbook of Medical-Surgical Nursing
Example text
Clinical Manifestations • Infection and the symptoms of anemia (eg, fatigue, pallor, dyspnea). • Retinal hemorrhages. • Purpura (bruising). • Repeated throat infections with possible cervical lymphadenopathy. • Other lymphadenopathies and splenomegaly sometimes occur. Assessment and Diagnostic Methods • Diagnosis is made by a bone marrow aspirate that shows an extremely hypoplastic or even aplastic (very few to no cells) marrow replaced with fat. Medical Management • Those who are younger than 60 years, who are otherwise healthy, and who have a compatible donor can be cured of the disease by a bone marrow transplant (BMT) or peripheral blood stem cell transplant (PBSCT).
Pulmonary function is monitored and pulmonary hypertension is treated early if found. Infections and acute chest syndrome, which predispose to crisis, are treated promptly. Incentive spirometry is performed to prevent pulmonary complications; bronchoscopy is done to identify source of pulmonary disease. • Fluid restriction may be beneficial. Corticosteroids may be useful. • Folic acid is administered daily for increased marrow requirement. • Supportive care involves pain management (aspirin or NSAIDs, morphine, and patient-controlled analgesia), oral or IV hydration, physical and occupational therapy, physiotherapy, cognitive and behavioral intervention, and support groups.
Provide written and verbal instructions about the administration of mineralocorticoid (Florinef) or corticosteroid (prednisone) as prescribed. Improving Activity Tolerance • Avoid unnecessary activities and stress that might precipitate a hypotensive episode. • Detect signs of infection or presence of stressors that may have triggered the crisis. • Explain rationale for minimizing stress during acute crisis. Promoting Home- and Community-Based Care Teaching Patients Self-Care • Give patient and family explicit verbal and written instructions about the rationale for replacement therapy and proper dosage.