Question

1. A 17-year-old girl has had a headache, chills, malaise, and fatigue for the past week. She reports that her throat is very sore. Her leukocyte count is very high at 18,000//L of blood. On physical examination, she has an enlarged liver and spleen, and she has enlarged lymph nodes in the anterior and posterior chains of her neck. The client states that three other kids at school have been sick this past week with similar symptoms. a. ‫Why is the clientâ€TMs immune system reacting this way? b. ‫The client believes she will die because one of the students at school said, åbæWe are going to have this all our lives.†What can the nurse say to relieve her fears? 2. A 28-year-old man has recently been diagnosed with schizophrenia. He has been started on clozapine (Clozaril), an antipsychotic medication. The client is required to have blood work taken every week to ensure his white blood cell counts are within normal ranges (5000€ 10,000/1/4L of blood). His older sister accompanies him to clinic today, as the client is having difficulty understanding why he has to have such frequent blood work. His sister states every week an argument erupts, and getting blood drawn every week is becoming a struggle. a. ‫What critical aspects of hematopoietic function is it important for his sister and the client to understand? 3. A 73-year-old man has worked as a professional gardener for most of his life after he came home from the Vietnam war. He has been experiencing a lot of pain in his lower extremities and has had two pathologic fractures of his right wrist over the past 6 months. He has lost about 20 pounds and has generalized weakness. a. €«What does the clinic nurse suspect is happening with the client? b. &E What treatment options can be explored with the client at this time? 4. A 28-year-old woman is at 34 weeksä€TM gestation with her second child. At this prenatal visit, her blood pressure is extremely high and there are no audible fetal heart tones. Her obstetrician admits her for an emergency cesarean birth under general anesthetic. The baby boy is stillborn. Immediately after closure of the wound, the client starts to have excessive bleeding and clotting from her vagina and abdominal incision. The client is transferred to ICU and given 8 units of FFP and 6 units of platelets. a. †Why does the ICU team need to determine the clientâ€TMs primary problem? b. «E<Twenty-four hours after admission to the ICU, the client dies. Explain why this happened.

Answer 1

1(A) Patient signs and symptoms explicate ,she has Non-hodgkin lymphoma.Enlarged lymph nodes are seeing most commenly in patient with lymphmoa .moreover, she has fever,malaise fatigue,lymhomas are due to cancerous lymhocytes (either B cells or T cells) .Lymphoma in the bone marrow can take up the space needed for normal blood cells to develop ,including other types of white blood cell tha fight infection, as lymphocytes are part of the immune system,some parts of the immune system may not work as well as normal in people who have lymphoma .Even if they are not cancerous .Hodgkin lymphoma ,these immune cells are abnormal and cannot protect patent as well .lymphoma weaken the immune system by spreading in to bone marrow.

1(B)The nurses can play key role to relieve the fear of the patient with disease,nurse can give strong psychological support to her to relive her strss and raises existential issues,the nurse can discussing existentially related conserns may be in abetter position to premote the patients psychological adptation.she can provide patient education meterials and offer support in managing affairs.

2(a)the critical aspects of hematopoietic function needs to be explain to the patient and his sister ,that patient are taking clozapine require onging monitoring because of the risk of serious blood dyscrasis .the drug leads to serious side effect such as neutropenia,agranulocytosis.seizures ,myocarditis and cardiomyopathy so its very important explain the patent and his sister.

3(a)joint and nerve pain in legs are common symptom of age especially people over 50 most leg pain is not medical emergency but is caused by wear and tear especially related to OSTEOARTHARITIS on the joints or injuries to the bones and ligaments allready patient has the history of fracture in wrist.

3(b)the nurse can explain to him its related to old age (artharitis) or other causes like neuropathies and he can take safest oral OTC pain killer as per doctor order ,exercise and physical therapy as per physician order.

4(a)the client has preeclampsia ,

4(b)due blood loss