About
Increased volume of erythrocytes; hematocrit will be elevated more than 50% of normal. Can be a precursor to Acute Myeloid Leukemia where there is an elevation of immature cells.
Assess
Elevated hematocrit, greater than 50% of normal, elevated leukocytes, erythrocytes, and platelet counts, enlarged spleen, headache, dizziness, fatigue, chest pain, blurred vision, elevated blood pressure, increased viscosity of blood, itching, parasthesias, thrombophlebitis.
Complications
DVT, CVA, MI, bleeding, hematuria, gastric bleeding, hemorrhage, Acute Myeloid Leukemia
Diagnosis
- Knowledge deficit related to treatment, disease, and risk factors.
- Altered comfort related to symptoms of disease including itching, numbness, tingling.
Goals
- The client will state understanding of treatment approaches and plan.
- The client will be able to identify factors that increase the likelihood of blood clot formation.
Interventions
- Assess vital signs, especially blood pressure, CBC, pain level.
- Assess client understanding of disease and associated treatments.
- Teach client about disease, treatment approaches ( phlebotomy, chemotherapy), and potential complications of disease.
- Teach client factors that can increase the likelihood of clotting, including smoking, obesity, crossing legs, wearing tight clothing.
- Teach client to ambulate frequently to avoid clot formation in the lower extremities.
- Encourage client to take cool baths with anti-itching preparations to help with pruritis.
- Teach client to avoid iron and iron supplements.
- Teach client signs and symptoms of complications and when to receive immediate medical attention.
- Administer chemo agents, low dose aspirin ( unless active bleeding or elevated platelet count) as indicated by physician.
- Monitor for signs and symptoms of complications.
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