Need help reading labs really bad at putting it together - page 2

I'm a nursing student and have a patient i have to give care to tomorrow and they have myasthenia gravis and their lymph count is high. And I need help so if anyone has any websites I would... Read More

  1. by   Daytonite
    You are welcome. You will also get an e-mail with my post. You'll get the hang of how this system works! I'll be hanging out on this site for awhile yet tonight if you need any more help.
  2. by   kisno
    Quote from Daytonite
    The high lymph count is not generally a symptom of the MG itself although it is common for MG patients to have autoimmune disease as well going on. However, an elevated lymph count indicates a possible infectious process or even a possible leukemia going on as well. The monocyte count gets elevated when the patient's immune system is attempting to replace active granulocytes that are catabolizing debris from the process of phagocytosis.

    Patients with elevated lymph counts will be lethargic, weak, fatigue easily, and may have dyspnea on exertion. That is where you go with your care plan. Address and monitor for these possibilities. You would also monitor a patient with high lymph counts for fever, acute chest pain, and chills (in other words, symptoms of infection or sepsis). So, what will you as a nurse do? You will monitor their labwork, take temps every 4 hours, assess the patient for symptoms of infection or sepsis, make sure they have assitance when they ambulate, instruct them to call for help to go to the bathroom, change the linens if they become diaphoretic so they are comfortable and give antipyretics. Now, put this into care plan form.

    I was making dinner so I wasn't really able to read you memo but I just did and it really rocks and helped me start my other care plans by putting things into perspective. I know that sounds confusing but seriosly last semester I had a teacher that just knocked my self esteem down and now I'm almost afraid to try. Really I'm not being dramatic that really helped. Thanks
  3. by   Daytonite
    When I first started in nursing, we didn't have to do the nursing diagnosis approach to care plans. We very simply listed patients problems on one side of the Kardex and our nursing instructions for the staff on the other side. It made it, Oh, so much easier. Then, when nursing diagnosis started being used I had to learn to kind of back into a whole new way of writing these things up. For me, using nursing diagnosis has been like coming from another country where they speak another language. I have to think in my native language (nursing problems) and then translate it into the new language (nursing diagnosis). Maybe that will help you out. When care planning I start with the patient's medical diagnoses and then make a mental list of what the nursing problems are going to be for those diseases. Then I include what kind of symptoms the patient actually has. That list of disease symptoms is then turned into nursing diagnoses. Any of the symptoms he doesn't have come under the nursing diagnosis of "Potential for. . ." At least, that is how I look at all this. To "individualize" the care plan you grab onto the symptoms the patient is actually presenting and make specific detailed instructions just for that patient. So, for instance, in the case of your MG man (or lady). . .if you know they are very weak and unsteady on their feet you are going to have nursing instructions under the "Potential for injury due to weakness" (I'm talking about potental falls here) such as, instruct patient to call for help when getting up to the bathroom, nursing staff to check patients room every 15 or 30 minutes and inquire if he needs any help with any activity, make sure his walker is at bedside and in reach, check to see that callbell is in reach of his right side (he's right handed) each time staff leaves the bedside. That kind of stuff.
  4. by   cardiacRN2006
    Daytonite, you rock at care plans!

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