Handicap: societal participation is used in WHO classification system, instead of handicap, to acknowledge that the environment is always interacting with people to either assist or hinder participation in life activities

Functional Independence Measure for Chronically Ill: measures if a patient can do ADLs independently

Bleeding precautions:

o NO IM injections (minimal injections even Subcut)

o Apply pressure for 5 minutes

o Use electric razor

o Soft bristle toothbrush

o No rectal anything

o No vigorous sex

o No contact sports

Neutropenic precautions:

o No fresh fruits or flowers, or meats

o No raw foods

o No crowds

o Wash hands!!!

o No children

o Peel fruits

o Talk over the phone instead of having visitors

Blood Transfusions: Acute hemolytic reaction

o S/S of transfusion reactions: fever, chills, respiratory distress, low back pain, nausea, pain at IV site

o Interventions: Determine client’s allergies & previous transfusion reactions

o Administer within 30 min. of receiving from blood bank

o First 15 minutes: 25-50 mL slowly, after 15 min. increase to 250-500 mL/hr

o Never add any meds to blood products

o Check crossmatch record with 2 nurses

o Infuse each unit over 2-4 hours but no longer than 4 hours

o Severe reactions in first 15 min.

o Blood tubing changed after 4 hours

o If there is a reaction, STOP TRANSFUSION IMMEDIATELY

o Maintain IV line (keep vein open) with NS with NEW TUBING at a slow rate

o Asses patient (vital signs) for other signs of reaction

o Notify HCP & then blood bank & send blood product with tubing back to blood bank

o Document

o Risks: arm stiffness and ringing in ears are complications of blood transfusions

Anemia:

o Patho: condition in which the hemoglobin concentration is lower than normal

o S/S: fatigue, dyspnea, tachycardia, confusion, weakness, general malaise, pallor of skin & mucous membranes, N/V, anorexia, glossitis, cheilosis (cracks in corners of mouth), smooth sore tongue, pica (craving for ice or clay)

o Diet: organ meats, beans, green leafy vegetables (fried liver & spinach)

o Interventions: Manage Fatigue

o Maintain adequate nutrition (red/organ meats)

o Maintain adequate perfusion

o Risks: Heart failure, angina, paresthesias, confusion, delirium, injury r/t falls, depressed mood

Iron Deficiency Anemia:

o Patho: anemia caused by dietary problems (low iron), chronic blood loss, or malabsorption

o Most common for women during menstruation; men GI bleeds

o Microcytic hypochromic

o S/S: smooth sore tongue, brittle & ridged nails, cheilosis (cracks in corner of mouth)