HIV, Cancer, Hematologic Disorders, Musculoskeletal Disorders, & Gastrointestinal Disorders

What are the labs and diagnostic tests for Iron-Deficiency Anemia?

• serum blood draw

• stool for occult blood

• colonoscopy

• gastroscopy

What are some nursing actions and interventions for patients with Iron-Deficiency Anemia?

• give supplemental O2 if needed

• give high iron diet

• give supplemental iron

What are some patient teachings for Iron-Deficiency Anemia?

• tell pt. to take supplemental iron

• tell pt. iron can cause dark stools

• tell pt. iron supplements can cause constipation so have a high fiber diet, stay hydrated, and use stool softeners  

• tell pt. to take iron supplements before meals

• tell pt. to take with vitamin C (orange juice) 

What are some nursing actions and interventions for patients with Sickle Cell Anemia?

• give pt. supplemental O2

• let pt. rest

• give oral and IV fluid replacement to dilute blood

• administer antibiotics as ordered

• give blood transfusion when ordered

• give morphine for pain

What are some patient teachings for Sickle Cell Anemia?

• tell pt. to limit physical activity

• tell pt. to stay hydrated

What is the lab and diagnostic test for Leukocytosis?

CBC (high WBC, band neut, metamyelocyte)

What are some nursing actions and interventions for patients with Leukocytosis?

• give antipyretics for fever

• collect cultures as needed to determine cause of increase white blood cells

• administer antibiotics when ordered

• review CBC

What are some nursing actions and interventions for patients with Leukopenia?

• give antibiotics when ordered

• have strict handwashing

• monitor pt.’s temperature every 4 hours

• give WBC stimulating medications when ordered

• do reverse isolations to keep pathogens from pt.

• monitor CBC

What are some labs and diagnostic tests for Leukemia?

• blood marrow aspiration 

• CBC (high WBC, Blasts, Metamyelocytes, Myelocytes, Promyelocytes, Basophils)

What are some nursing actions and interventions for patients with Leukemia?

• monitor for infection

• let pt. rest

• do bleeding precautions

• do reverse isolation when indicated

What are some nursing actions and interventions for patients with Multiple Myeloma?

• monitor for infections

• monitor for bleeding

• fracture precautions

• monitor calcium levels

What are some nursing actions and interventions for patients with Thrombocytopenia?

• monitor for intracranial hemorrhage & intra-abdominal bleeding

• platelet infusions as ordered

• do not do IM injections, NG tubes, urinary catheters

• do not give antiplatelet medications or NSAIDs

What is the lab and diagnostic test for Aplastic Anemia?

CBC (low red blood cells, hemoglobin, hematocrit, white blood cells, neutrophils, platelets)

What are some nursing actions and interventions for patients with Aplastic Anemia?

• monitor for infections

• put pt. on bleeding precautions

• administer O2 for shortness of breath

• let pt. rest

• do blood transfusions as needed

• administer steroids and neupogen when ordered

What are some nursing actions and interventions for patients with Polycythemia Vera?

• do therapeutic phlebotomy (taking blood from pt.)

• monitor I&Os

• administer medications to reduce platelet count

• put pt. on deep vein thrombosis precautions

• do active and passive range of motion exercises with pt. 

• schedule phlebotomy every 2-3 months

What are some patient teachings for Polycythemia Vera?

• tell pt. to increase fluid intake 

• tell pt. they will need to phlebotomy every 2-3 months to get rid of extra blood

What are some signs and symptoms of Repetitive Strain Injury?

• pain in affected area

• weakening in affected area

• numbness of extremity

What are some signs and symptoms of an ACL Injury?

• pt. states they heard a loud pop

• knee pain

What are some nursing actions and interventions for patients with an ACL Injury?

• keep pt.’s leg elevated

• administer NSAIDs when ordered

What are some patient teachings for an ACL Injury?

• tell pt. they do not need to have surgery right away

• tell pt. to elevate their affected knee

• tell pt. to ambulate on leg as tolerable 

• tell pt. they can take NSAIDs for pain

What are some signs and symptoms of Bursitis?

• warmth on affected area

• pain on affected area

• limited range of motion of the affected area

What are some nursing actions and interventions for patients with Bursitis?

• elevate the extremity

• keep the affected extremity immobilized and at rest

• administer NSAIDs when ordered

What are some patient teachings for Bursitis?

• tell pt. to rest extremity with immobilization

• tell pt. to ice affected area

• tell pt. to take NAIDs when prescribed

What are some signs and symptoms of Fractures?

• pain/tenderness over involved area

• decreased or loss of muscular strength or function

• obvious deformity of affected area

• crepitation and erythema

• edema and bruising around affected area

• muscle spasm and neurovascular impairment

What are some nursing actions and interventions for patients with Fractures?

• if suspected Compartment Syndrome: notify HPC immediately and loosen tight dressings or viable restrictive cast 

• if suspected fat embolism: give supplemental oxygen, make sure pt. has IV for medication, monitor vitals, monitor respiratory stats 

What are some patient teachings for Fractures?

• tell pt. to keep cast dry 

• tell pt. to report pain, swelling, or discoloration to distal extremity to cast 

• teach pt. R.I.C.E.

• tell pt. to report sores or foul odor under cast

• tell pt. they can dry cast with hair dryer on low, cool setting of cast gets wet

What are some patient teachings for Osteomyelitis?

• tell pt. they may go home with a PICC Line and IV antibiotics for 4-6 weeks

• tell pt. they may have to have a hyperbaric oxygen chamber at home

• tell pt. they may have long term myelitis

What are some signs and symptoms of Degenerative Disc Disease?

• radiculopathy and radiating pain down spine

• numbness and tingling in spine

• decreased strength in spine

• limited range of motion in spine

What are some signs and symptoms of Osteoporosis?

• asymptomatic 

• several fractures within a short time frame

What are some patient teachings for Osteoporosis?

• tell pt. to take calcium carbonate with food

• tell pt. to take calcium citrate on an empty stomach 

• tell pt. to take bisphosphonates with water, sit up for 30 minutes, take for at least 5 years, and wait at least 30 minutes before eating

• tell female pt. to take 1000 mg/day calcium (19 to 50 years)

• tell female pt. to take 1200 mg/day calcium (51 years and older)

• tell male pt. to take 1000 mg/day calcium (19 to 70 years)

• tell male pt. to take 1200 mg/day calcium (71 years and older)

• tell pt. to take 800 units of vitamin D daily

What are some signs and symptoms of Osteoarthritis?

• joint pain with movement or weight bearing

• stiff joints

• crepitus

• pain relief with rest

• enlargement of joints

• herberden’s nodes in distal joints

• bouchard’s nodes in hip joints

What are some patient teachings for Osteoarthritis?

• tell pt. they can take 200mg ibuprofen up to 4 times a day for pain

• tell pt. they can take isopropyl to decrease GI side effects

• tell pt. they can get intraarticular corticosteroid injections  every 3 months

• tell pt. they can do alternative therapies such as acupuncture, massage, or Tai Chi

• tell pt. to take fish oil or ginger for inflammation

What are some signs and symptoms of Rheumatoid Arthritis?

• morning stiffness in joints due to inflammation

• movement helps with joint stiffness 

• fever

• weight loss

• limited range of motion due to inflammation and pain

What are some patient teachings for Rheumatoid Arthritis?

• tell pt. that Methotrexate is used for early treatment 

• tell pt. that Sulfasalazine (Azulfidine) & hydroxychloroquine (Plaquenil) is used for mild to moderate rheumatoid arthritis  

• tell pt. if they are taking Sulfasalazine (Azulfidine) & hydroxychloroquine (Plaquenil), they need to have regular eye exams every 6-12 months 

• tell pt. Leflunomide (Arava) blocks immune cell overproduction 

• tell pt. they cannot have live vaccines of they are taking Biological Response Modifier

What are some signs and symptoms of Gout?

• acute onset of excruciating in joint

• redness around joint 

• nephrolithiasis (kidney stones) 

What are some nursing actions and interventions for patients with Gout?

• give oral colchicine when ordered

• administer NSAIDs when ordered

• administer corticosteroids when ordered 

• if pt. is taking Allopurinol, monitor liver levels

What are some patient teachings for Gout?

• tell pt. side effect of oral colchicine is diarrhea 

• tell pt. oral colchicine helps with inflammation

• tell pt. NSAIDs help with joint pain 

• tell pt. to not take colchicine or steroids when on NSAIDs

• tell pt. that aspirin does not work for pain due to gout 

• tell pt. to limit alcohol and food high in purine (beans, beer, red meats, fried foods, etc.)

What are some signs and symptoms of Systemic Lupus Erythematosus?

• butterfly rash across nose and cheeks

• heart dysrhythmias

• dry, scaly skin

• joint pain

• light sensitivity

What are some nursing actions and interventions for patients with Systemic Lupus Erythematosus?

• administer NSAIDs for joint pain when ordered

• administer antimalarial drugs for fatigue and skin & joint problems 

• administer corticosteroids for inflammation when ordered

• taper off and give at lowest effective dose of corticosteroids

• administer immunosuppressive drugs when ordered

• assess ADLs

• monitor neurological function

What are some patient teachings for Systemic Lupus Erythematosus?

• tell pt. there is not cure for SLE

• tell pt. to avoid crowded areas if taking immunosuppressive drugs 

• tell pt. they can apply topical immunomodulators for butterfly rash on face and discoid lesions

What are some nursing actions and interventions for patients with C-Diff Infection?

• disinfect everything with bleach when cleaning

• put pt. on contact isolation (gloves and gown)

• administer PO vancomycin

• administer fidaxomicin

• administer metronidazole

What are some patient teachings for C-Diff Infection?

• tell the pt. to clean everything they come in contact with with bleach

• tell pt. they can do a fecal microbiota transplantation (fecal pill)

What are some nursing actions and interventions for patients with Peritonitis?

• assess for abdominal distention

• assess pain, bowel sounds, and vital signs

• monitor I&Os

• monitor electrolyte levels

• assess NG tube if pt. is NPO

• administer oxygen as needed when ordered

What are some labs and diagnostic tests for Chron’s and Ulcerative Colitis?

• CBC

• Iron studies

• electrolytes levels

• stool examination and culture

• small bowel follow-through

• ultrasound

• CT scan

• MRI

• Colonoscopy

• endoscopy (diagnose crohn's disease if in small intestines)

What are some nursing actions and interventions for patients with Chron’s and Ulcerative Colitis?

• administer aminosalicylates when ordered

• administer biologics when ordered

• administer corticosteroids when ordered

• administer immunomodulators when ordered

• do enteral feedings for exacerbation 

• monitor I&Os

• obtain daily weights

What are some patient teachings for Chron’s and Ulcerative Colitis?

• tell pt. to take iron supplements 

• tell pt. to take zinc supplements

• tell pt. to take calcium supplements 

• tell pt. to contact provider if they experience frequent, watery stools, bloody stools, or extreme nausea and vomiting

What are some labs and diagnostic tests for Colorectal Cancer?

• colonoscopy (every 10 years)

• sigmoidoscopy (every 5 years)

• colon biopsies

• Ct scan

• PET scan

• MRI

• fecal occult blood tests (once a year)

• colaguard (every 3 years) 

• carcinoembryonic antigen to monitor for signs of recurrent colon cancer)

What are some patient teachings for Colorectal Cancer?

• tell pt. chemotherapy is used after surgery and is used for advanced stage 2 colorectal cancer

• tell pt. that stage 3 colorectal cancer is treated with anastomosis and chemotherapy

• tell pt. for stage 3 colorectal cancer, targeted therapy and chemotherapy are used for treatment 

• tell pt. radiation is used before surgery to shrink the size of the tumor

What are some labs and diagnostic tests for Hepatitis?

• antigen blood testing

• antibody blood testing

• AST and ALT

• RNA testing

• viral genotype testing

• liver biopsy

• fibroscan

What are some nursing actions and interventions for patients with Hepatis?

• administer nucleoside and nucleotide analogs when ordered

• administer interferon when ordered

• administer direct acting antiviral medications when ordered

• administer antihistamines & antiemetics

• give small, frequent meals

What are some patient teachings for Hepatis A?

• tell pt. it is transmitted through fecal-oral route

• tell pt. that once they get Hep A, their body will create antibodies (IGM and IGG)

• tell pt. that Hep A usually resolves on its own

• tell pt. virus stays in feces for up to 2 weeks before signs of infection occur

• tell pt. there is a vaccine for Hep A

What are some patient teachings for Hepatis B?

• tell pt. Hep B is transmitted through blood

• tell pt. Hep B can be transmitted to baby during birth

• tell pt. that if they have Hep B, they can also get Hep D

• tell pt. that vaccinating against Hep B can help immunization for Hep D

What are some patient teachings for Hepatis C?

• tell pt. Hep C is transmitted through blood (RNA virus)

• tell pt. there is no vaccine for Hep C

• tell pt. they are at a higher risk for getting Hep B & HIV

• tell pt. there is a cure for Hep C

What are some patient teachings for Hepatis D?

• tell pt Hep D cannot survive without Hep B

• tell pt. Hep D is transmitted by blood

• tell pt. Hep D is from Delta virus

What are some patient teachings for Hepatis E?

• tell pt. Hep E is transmitted through fecal-oral route 

• tell pt, Hep E is usually transmitted through contaminated water

What are some labs and diagnostic tests for Acute Pancreatitis?

• serum amylase

• lipase

• abdominal ultrasound

• CT scan

• endoscopic retrograde cholangiopancreatography 

• x-ray

What are some nursing actions and interventions for patients with Acute Pancreatitis?

• give pt. continuous IV fluids

• give pt. IV narcotics

• give supplement O2 when ordered

• do NG suctioning

• administer protein pump inhibitor medications when ordered

• administer antacids when ordered

• administer analgesics when ordered 

• give small, frequent meals

• give enteral feeding if pt. is NPO

• monitor glucose levels

What are some patient teachings for Acute Pancreatitis?

• tell pt. to have small, frequent meals

• tell pt. to have a complex carb, low fat diet

What are some nursing actions and interventions for patients with Chronic Pancreatitis?

• administer pancreatic enzyme replacement 

• monitor stools of pt. is on pancreatic enzyme replacement

What are some patient teachings for Pancreatic Cancer?

• tell the pt, that smoking increases the likelihood of developing pancreatic cancer. adenocarcinoma by 2 to 3 times

• tell pt. that the life expectancy is 5-12 months after diagnosis

• tell the pt. that there is a 9% survival rate

• tell pt. they can do chemotherapy and radiation therapy  

What are some labs and diagnostic tests for Cholelithiasis and Cholecystitis?

• abdominal ultrasound

• endoscopic retrograde cholangiopancreatography

• percutaneous transhepatic cholangiography

• CBC (WBC), bilirubin, AST,ALT

• amylase 

What are some nursing actions and interventions for Cholelithiasis and Cholecystitis?

• administer vidal acids for gallstones

• administer antibiotics when ordered

• administer antiemetics when ordered

• administer bile salts when ordered

• give small, frequent meals

• give low fat, high fiber & calcium diet

• monitor electrolyte levels

What are some patient teachings for Cholelithiasis and Cholecystitis?

• tell pt. to do small, frequent meals

• tell pt. take have a low fat, high fiber & calcium diet

• tell pt, to avoid rapid weight loss if possible