Charlie Cobalt 64 yo Has been working in the factory for 35 years and is 1 year away from retirement. He comes in today c/o fatigue and SOB. CBC RBC 2.5 WBC 2.5 Hgb 8.2 Hct 20 Platlets- 24,000 Dx: Aplastic Anemia

Tx: Blood Transfusion Bone Marrow replacement AB’s Corticosteroids No more factory!

Nursing Dx: Potential for infection Activity intolerance Potential for hemorrhage Fear Knowledge deficit

Jimmy Sutton 8yo Comes in complaining of severe fatigue, weakness, loss of appetite, and “sick”. CBC RBC-3.2 WBC- 40,000 Hgb- 8.4 Platlets- 23,000

Dx: Possible ALL Leukemia is a cancer of the blood manufacturing centers. 2 types: Lymphocytic and Myelogenous 2 types: Acute and Chronic Confirm Dx? Bone marrow biopsy Tx: Chemotherapy Ax for infections (Cloudy urine, chest congestion) due to neutropenia.

Nursing Dx: Potential for infection Activity intolerance Impaired mucus membrane Knowledge deficit Fear Potential for hemorrhage (Small needles) Nutrition: < body requirements (Stomatitis)

Thomas Wheeling: In a fight after a soccer game. Unable to speak. CT Clean and dress wounds. Labs: HgB- 6.2 HcT Transfuse Blood ASAP Which? How? Signs of Reaction Big fever Flushed/Itching Dyspnea If seen do what?

Carlos is a 6 yo boy. He was brought in by his Mother C/O severe pain in his left knee Why? Obtain Hx US? History of Hemophilia How? From Mom (Carrier) to son. Dx: Internal bleeding in joint. Tx: Prevent injury, Infuse clotting factors Nursing Dx: Potential for…

Kris is a 3 yo female brought in by her mother. Mother reports she fell on tiled floor at home while playing with her brother. Bruising of face and body covered with purpura and petechiae. Abuse? Labs: HgB Hct- 39 Platelets- 50,000 Dx: Thrombocytopenia Tx: Prevent further injury!!! Small needles

Sally is a 8 yo with a history of Leukemia. She was brought in by her father with c/o “Not feeling well” and cloudy urine. She finished her last round of chemo 3 days ago. Labs: WBC: 500 Platlets: 74,000 Dx: Leukemia, Stomatitis, Thrombocytopenia, Urinary infection Tx: Neutorpenic precautions Soft foods Prevent injury AB’s Nursing Dx: Potential for.. Impaired oral mucus membranes

Carlton is a 28 yo male with a history of sickle cell anemia. Comes in today c/o severe abd. and leg pain. Dx: Sickle Cell Crisis How? Stress on body Dehydration Infection Smoking Tx: Treat the pain Infuse? Hydroxyurea? Treat the cause Nursing Dx: Pain! Knowledge deficit?

Michelle is a 17 yo female with c/o severe weakness, fatigue, and numbness and tingling in arms, and cold all the time History: Partial gastrectomy 8 months ago for weight issues Labs: HgB: 8.1 HcT: 32 Dx: Pernicious Anemia Tx: B12 1 x month for life Nursing Dx: Activity intolerance (rest periods)