Lewis: Medical-Surgical Nursing, 8th Edition

Chapter 30: Nursing Assessment: Hematologic System Assessment Case Study Patient Profile L.T., a 54-year-old woman, has come to your clinic for a follow-up visit to discuss her persistent fatigue. You bring her into the examining room, provide her with a gown to change into, and return a few minutes later to gather some preliminary data. As you open her chart, you find the results of her laboratory tests that were obtained 2 days ago. Her white blood cell count is 104,000 cells/L and her lymphocyte count is 52%. Her hematocrit is 28%, and her platelet count is 120,000 platelets/L. While you are looking at the chart, she says, I found some lumps in my armpit and neck. What do you think that is from? Brainstorming 1. What alterations or abnormalities can cause lumps in the groin, armpits, neck, and head? What body systems are involved? 2. Would you do a comprehensive, focused, or emergency assessment of that system? 3. What illnesses or conditions may cause the lumps? Subjective Assessment 4. To obtain additional information what key assessment questions will you ask her? Objective Assessment 5. What descriptors apply to this type of lump? 6. What other places in the body should be checked for similar lumps? Extra Credit 7. This is a rather ominous diagnosis suggested by lymphadenopathy, fatigue, and her blood cell counts. What could it be? More importantly, what is the role of the registered nurse (RN) in this visit?

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