Case 2 (Chapter 21): Alterations in Hematologic Dysfunction
Source: Lewis, S. L., Heitkemper, M. M., Dirksen, S. R, O’Brien, P. G., & Bucher, L. (2007). Medical-surgical nursing (7th ed.). Mosby.
J.J., a 35-year-old white man, went to the emergency room because of severe bruising caused by a fall while hiking. He complains of oral pain and white patches covering his tongue. He has had a 2-month history of fatigue, malaise, and flu-like symptoms. He has taken numerous prescribed antibiotics and increased rest and sleep in the past 2 months without relief of symptoms. His physical examination shows the following: Bruises and ecchymoses from his fall, gingiva with petechiae and patchy white spots, temperature of 39 degrees Celsius, with splenomegaly. Lab results include: hematocrit (30%); Hemoglobin (8.8 g/dl); white blood count (120,000/micro liter); platelet count (25,000/micro liter). Bone marrow biopsy results with multiple myeloblasts (greater than 50%).
Case Questions
What components of the laboratory test results suggest acute leukemia?
What are common clinical manifestations of leukemia and their related causes? Indicate which ones J.J. experienced.
How is myelogenous leukemia treated?
What is the prognosis for J.J.?
What are the life-threatening problems that can occur as a result of this disease and treatment? If you were the nurse, how could you anticipate and assess for these problems?
THE TEACHER ASSIGNED TO ME CASE STUDY #2 WHICH IS: Alterations in Hematologic Dysfunction
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