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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: 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 hygiene, underlying causes pharmacologic interventions 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, worse References 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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