Med-Surg Immune System, part 11: Neutropenia, Anemia, Thrombocytopenia

by Cathy Parkes October 08, 2020

In this video

Neutropenia

  • Definition of neutropenia
  • Neutropenic nursing care and hospital precautions
  • Medications for neutropenia (filgrastim)
  • Neutropenia patient teaching

Anemia

  • Definition of anemia
  • Medications for anemia
  • Patient teaching for anemia

Thrombocytopenia

  • Definition of thrombocytopenia
  • Nursing care for thrombocytopenia
  • Patient teaching for thrombocytopenia

Full Transcript

Alright. In this video, we are going to continue our coverage of common complications associated with cancer treatment and chemotherapy. Specifically in this video, we are going to talk about neutropenia, anemia, and thrombocytopenia.

So with neutropenia, neutropenia means we have insufficient numbers of neutrophils. So our patient's white blood cell count is down and they are at higher risk for infection.

So we need to implement neutropenic precautions at the hospital. So this is basically like reverse isolation. So instead of putting on protective gear to go in a patient's room to protect you from exposure, you're putting on that protective gear to help prevent exposure for the patient, right? We want to really make sure they don't get sick.

So in addition to neutropenic precautions, we're going to want to carefully monitor our patient's temperature.

We're going to restrict any visitors who are ill.

We want to not allow any fresh plants or flowers in the patient's room.

And we want to keep dedicated equipment in the patient's room, as well. So you want to keep a vital signs machine there in the patient's room. We don't want a vital signs machine kind of roaming from room to room and possibly contaminating the patient.

We can also give the patient a medication called filgrastim. So filgrastim helps to boost up the patient's neutrophil count. So the way I remember this medication and the cool chicken hint that's on our pharmacology cards is that filgrastim will help the patient "fill up" on neutrophils. So hopefully, that will help you remember that medication as well.

Patient teaching. When the patient does home, they need to take their temperature daily and definitely report any temperature above 100 degrees to their provider.

They should avoid crowds, avoid sick people.

They should not consume raw foods.

They should avoid yard work or gardening.

They should not change their cat litter box and they need to make sure they wash their dishes in hot water or use a dishwasher.

They should wash their toothbrush as well in the dishwasher daily or use a bleach solution to make sure that stays as clean as possible.

In addition to neutropenia, anemia is another common side effect with cancer treatment. This is where we have decreased red blood cell counts.

So medications we can provide to help with this condition include epoetin alfa, which helps to increase red blood cell count.

In addition, we're gonna want to provide ferrous sulfate, which is an iron supplement, because iron is a key component of red blood cells.

In terms of patient teaching, we're going to want to encourage the patient to increase increase their intake of foods that are high in iron folate and B12.

We also want to encourage them to take extra rest periods because anemia can make you feel very, very fatigued. So the patient needs to give themselves some grace and patience and just take those extra rest periods.

Another key side effect with chemotherapy and cancer treatment is thrombocytopenia. This is where we have decreased platelet counts. And that places the patient at high risk for bleeding.

So we are going to want to monitor for blood in the patient's stool, urine, and vomit.

We are going to avoid IVs and injections whenever possible. When it is not possible, and we do have to do a blood draw or some kind of injection, we want to make sure we hold prolonged pressure over the area to ensure the patient stops bleeding.

And then in terms of patient teaching, we want to encourage the patient to use an electric razor versus a straight razor.

They should use a soft toothbrush.

They should avoid blowing their nose vigorously.

They should avoid NSAIDs as well such as ibuprofen because those medications carry a side effect of GI bleeding, and we definitely do not need that.

And then, the patient should avoid falling whenever possible, so implement safety precautions because if the patient were to fall, they are at higher risk for bleeding, and this could potentially be fatal.

Okay. So that is it for this video. When we come back, we will get into specific types of cancer starting with skin cancer. Hopefully, this video has been helpful. If it has, be sure to like the video and subscribe to our channel. And thank you so much for watching!


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