الثلاثاء، 28 أغسطس 2018

251-Multiple Myeloma

About
Malignancy of the plasma cells resulting in impaired immunoglobulin function and decreased immune system response.
Assess
Bone pain ( back, ribs most commonly), hypercalcemia, idiopathic fractures, anemia, decreased platelets and leukocytes, neurological symptoms.
Complications
Renal failure, Infection, sepsis, DVT's, death.
Diagnosis
  • Knowledge deficit related to disease process and management
  • Pain related to disease process.
  • Ineffective coping related to concerns and fears regarding diagnosis and treatment.
  • Anticipatory grieving related to diagnosis and treatment.
  • Risk for infection related to immune system dysfunction and compromise.
  • Risk for injury.

Goals
  • The client will remain free form infection.
  • The client will state a pain level less than 4 after medication intervention.
  • The client will remain free from injury.
  • The client will identify signs and symptoms of infection.
  • The client will identify treatment options for disease.
  • The client will verbalize concerns and fears related to diagnosis and treatment options.
  • The client will identify methods to decrease the risk of infection.

Interventions
  • Assess pain levels, electrolytes, CBC, vitals, knowledge about disease and treatment options.
  • Monitor pain levels, calcium levels, BUN, creatinine, Urine output, activity levels.
  • Administer pain medications as ordered by physician.
  • Apply compression stockings and encourage activity and ambulation to prevent blood clots.
  • Encourage coughing and deep breathing exercises and incentive spirometry to prevent respiratory infections.
  • Administer chemotherapy and prepare for radiation therapy or bone marrow transplant as indicated by physician.
  • Provide opportunities for client to verbalize concerns, feelings, and fears related to diagnosis and treatment.
  • Teach client methods to prevent fractures or injury ( proper body mechanics, no lifting greater than ten pounds, use of braces for support, maintaining mobility).
  • Teach client signs and symptoms of infection or complications to report immediately to health care provider.
  • Teach client methods to prevent infection including hand-washing, avoiding large crowds, monitoring temperature.

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