mm-concept by nuhman10


									 Labs:                                            Dx & Patho: Multiple Myeloma---                                                          Clint Ludlow
 RBC-3.15, HGB-10.3, HCT-28.6                     Cause is unknown, but exposure to                                                        Concept Map
 Lymphocytes- 14.5,                               radiation and chemicals may play a role.                                                 440 Clinical
 Albumin- 3.1                                     Neoplastic plasma cells infiltrate the bone                                              Good Sam Hospital
                                                                                                         Clinical Manifestation:
 Total Protein- 6.0                               marrow and destroys bone. Body produces                                                  Instructor: Diane Ullman
                                                                                                         High protein levels               November 17, 2008
                                                  abnormal amounts of interleukins which                 from myeloma protein
                                                  also causes destruction. So too many                   can cause renal
    Clinical Manifestation:                       immunoglobulins and interleukins cause
    Skeletal pain, Osteoporosis,                                                                         failure, anemia
                                                  bone destruction and so body doesn’t have
    vertebral destruction-collapse,               normal immune response/cells.
    hypercalcemia/bone loss,
    anorexia, anemia

                                                                                                                                Nsg Dx:
                                                                                Nsg Dx:                                         Risk for infection r/t becoming
                                       Nsg. Dx: Imbalanced                      Impaired bed mobility r/t fatigue               immunocomprimised from chemo aeb
Nsg. Dx: Pain r/t                      nutrition: less than body
compression fractures aeb                                                       aeb inability to get out of bed                 50-70% of MM pt’s will die because of
                                       requirements r/t MM anorexia                                                             bacterial infections
pt stating current pain level          aeb loss of body weight.
on a 0-10 pain scale.                  .
                                                                        Labs: Albumin, Hgb,                         Labs:                                   WBC, Creatinie,
                                Labs: RBC, Hct,                         Hct, electrolytes,                          Albumin, RBC, Hgb,                      albumin
                                albumin                                                                             Hct, total protein

          Intervention:                           Intervention:                               Intervention:                              Intervention:
          Assistance in                           Consult with                                Weight bearing                             Wash hands or
          ambulation,                             dietician,                                  activities,                                use gel, keep
          analgesic                               encourage snacks                            encourage                                  incisions clean,
          administration,                         and juices,                                 ambulation,                                appropriate pt
          utilize non-                            multivitamin, any                           encourage fluids
                                                  underlying causes

        Evaluation:                                Evaluation:                                Evaluation:                                Evaluation:
        Assess pain location,                      Record I & O’s, daily                      Activities tolerated,                      Assess wounds Q 4 hrs,
        duration, type, quality,                   weights, assess skin/hair,                 distance ambulated,                        immunization records,
        frequency, intensity,                      assess energy level, check                 energy level                               bladder function (UTI)
        what makes it better-                      labs/albumin,

1. Huether, S. E.; McCance, K. L. (2004). Understanding Pathophysiology. Missouri: Mosby, Inc.

2. Lewis (2007). Medical-Surgical Nursing: Assessment and management of clinical problems. Missouri: Mosby, Inc.

3. Ackley, J. A.; Gail, B. L. (2006). Nursing Diagnosis Handbook: A guide to planning care. Missouri: Mosby, Inc.

4. Dirksen. (2007). Medical-Surgical Nursing: Clinical companion. Missouri: Mosby, Inc.

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