MAMALUMPONG JORDAN A.

BSN-3
NCM 112
ASSIGNMENT
1. Identify the risk factor for development of infection & bleeding in patients with hematologic
disorders
 Cardiovascular Effects
Hypertension
Thrombophlebitis
Thromboembolism
Accelerated atherosclerosis
 Immunologic Effects
Increased risk of infection and masking of signs of infection
 Ophthalmologic Changes
Glaucoma
Corneal lesions
 Musculoskeletal Effects
Muscle wasting
Poor wound healing
Osteoporosis with vertebral compression fractures, pathologic fractures of long bones, aseptic
necrosis of head of the femur
 Metabolic Effects
Alterations in glucose metabolism
Steroid withdrawal syndrome
 Changes in Appearance
Moon face
Weight gain
Acne
 Fluid and Electrolyte Imbalance
2. List down the nursing process for neutropenia precautions
Risk of Infection
 Severity of neutropenia: Risk for infection is proportional to severity of neutropenia.
 Duration of neutropenia: Increased duration leads to increased risk of infection.
 Nutritional status: Decreased protein stores lead to decreased immune response and energy.
 Deconditioning: Decreased mobility leads to decreased respiratory effort, leading to increased
pooling of secretions.
 Lymphocytopenia; disorders of lymphoid system (chronic lymphocytic leukemia, lymphoma,
and myeloma): Decreased cell-mediated and humoral immunity.
 Invasive procedures: Break in skin integrity leads to increased opportunity for organisms to
enter blood system.
 Hypogammaglobinemia: Decreased antibody formation.
 Poor hygiene: increased organisms on skin and mucous membranes, including perineum.
 Poor definition; mucositis: Decreased endothelial integrity leads to increased opportunity for
organisms to enter blood system.
 Antibiotic therapy: Increased risk for superinfection, often fungal.

Risk of Bleeding
 Severity of thrombocytopenia: Risk increases when platelet count decreases; usually not a
significant risk until platelet count is less than
10,000/mm3, or less than 50,000/mm3 when invasive procedure is performed.
 Duration of thrombocytopenia: Risk increases when duration increases.
 Sepsis: Mechanism unknown; appears to cause increased platelet consumption.
 Increased intracranial pressure:
Increased blood pressure leads to rupture of blood vessels.
 Liver dysfunction: Decreased synthesis of clotting factors.
 Renal dysfunction: Decreased platelet function
 Dysproteinemia: Protein coats surface of platelet, leading to decreased platelet function;
protein causes increased viscosity, which lead to increased stretching of capillaries and thus
increased bleeding.
 Alcohol abuse: Suppressive effect on marrow leads to decreased platelet production and
decreased ability to function; decreased liver function results in decreased production of
clotting factors.
 Splenomegaly: Increased platelet destruction; spleen traps circulating platelets.

List down the nursing process for neutropenia precautions

Instruct/advise patient to:
3. What are the complications associated with corticosteroid therapy?
•  Retarded longitudinal growth
•  Steroid myopathy in children
•  Hypertension
•  GI Bleeding
•  Cataracts
•  Osteoporosis
•  Psychiatric
•  Diabetes
•  Adrenal suppression
•  Cushing Syndrome
 Complications to remember