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NCP-ITP

NCP-ITP

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Published by Joy Roa

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Published by: Joy Roa on Jul 12, 2011
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08/29/2013

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NCP Nursing Care PlansFor AplasticAnemia. Aplastic, or hypoplastic, anemia is a bone marrow failure that is characterized by a decrease in all formed elements of peripheral blood and its bone marrow. If allelements are suppressed resulting in loss of production of healthy erythrocytes, platelets, and granulocytesthe condition is known as pancytopenia. Onset is often insidious and may become chronic; however, onsetmay be rapid and overwhelming when the cause is a myelotoxin. Aplastic and hypoplastic anemia arepotentially fatal, commonly used interchangeably with other terms for bone marrow failure, aplastic anemiacorrectly refer to pancytopenia resulting from the decreased functional capacity of a hypoplastic, fatty bonemarrow. These disorders usually producefatal bleeding or infection, particularly when they're idiopathic.
CausesFor Aplastic Anemia
Injury or damage to the stem cells that inhibit red blood cell (RBC) production.
Complications For Aplastic Anemia
Life-threatening hemorrhage from the mucous membranes is the most common complication of aplastic or hypoplastic anemias because affected patients develop alloimmunization, which can make platelettransfusions ineffective. Immunosuppression can lead to secondary opportunistic infections.
The patient's history may not help to establish disease onset because the symptoms usually developinsidiously. The patient may report signs and symptoms of anemia (progressive weakness and fatigue,shortness of breath, and headache) or signs of thrombocytopenia (easy bruising and bleeding, especiallyfrom the mucous membranes [nose, gums, rectum, vagina]).Inspection may reveal pallor if the patient is anemic, and ecchymosis, petechiae, or retinal bleeding if thrombocytopenia is present. You may note alterations in the level of consciousness and weakness if bleeding into the central nervous system has occurred.Auscultation may reveal bibasilar crackles, tachycardia, and a gallop murmur if severe anemia results inheart failure.The patient may also have signs and symptoms of an opportunistic infection (most commonly, a bacterialinfection). Fever, oral and rectal ulcers, and sore throat may indicate the presence of an infection but withoutcharacteristic inflammation due to leukopenia.
Diagnostic tests For Aplastic Anemia
Complete blood count
Serum iron; coagulation tests; bone marrow biopsy; hemoglobin electrophoresis;
transaminase; bilirubin; lactic dehydrogenase; blood urea nitrogen; creatinine;
hepatitis testing; peripheral smear.
Nursing diagnosis Nursing Care Plans For Aplastic Anemia
Acute pain
Fear 
 
Ineffective thermoregulation
Risk for deficient fluid volume
Nursing outcomes Nursing Care Plans For Aplastic Anemia
Nursing Key outcomes Nursing Care Plans For Aplastic Anemia, Patient will;
State the need to increase activity level gradually and the importance of rest periods.
Express feelings of comfort and decreased pain.
Identify measures to prevent or reduce fatigue.
Verbalize fears and concerns.
Oral mucous membranes will remain intact.
Maintain a normal body temperature.
Maintain adequate fluid balance.
Free from signs and symptoms of infection
Nursing interventions Nursing Care Plans For Aplastic Anemia
To identify causative/precipitating factors. Assist client to deal with contributing factors and manageactivities within individual limits. Activity Therapy Prescription of and assistance with specificphysical, cognitive, social and spiritual activities to increase the range, frequency, or duration of anindividual’s or group are activity. Energy Management Regulating energy use to treat or preventfatigue and optimize function
Pain Management Alleviation of pain or a reduction in pain to a level of comfort that is acceptableto the patient. Analgesic Administration Use of pharmacologic agents to reduce or eliminate pain.Environmental Management Manipulation of the patient’s surroundings for promotion of optimalcomfort
Energy Management regulating energy use to treat or prevent fatigue and optimize function.Exercise Promotion Facilitation of regular physical exercise to maintain or advance to a higher levelof fitness and health. Nutrition Management Assisting with or providing a balanced dietary intake of foods and fluids
Anxiety Reduction Minimizing apprehension, dread, foreboding, or uneasiness related to anunidentified source or anticipated danger. Security Enhancement Intensifying a patient’s sense of physical and psychological safety. Coping Enhancement Assisting a patient to adapt to perceivedstressors, changes, or threats that interfere with meeting life demands and roles
Oral Health Restoration, Oral Health Maintenance, Promotion of healing for a patient who has anoral mucosa or dental lesion. Maintenance and promotion of oral hygiene and dental health for thepatient at risk for developing oral or dental lesions. Promotion of oral hygiene and dental care for apatient with normal oral and dental health
Temperature Regulation: Attaining and/or maintaining body temperature within a normal range.Fever Treatment Management of a patient with hyperpyrexia caused by nonenvironmental factors

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