Possible leukemia???

Daytonite, BSN, RN · Oct 30, 2008

As nurses we treat the responses the patient is having, not the medical disease. That is the doctor's territory. Don't misunderstand me. I understand the curiosity to know what is going on with the patient. And, you may very well be right, but there is a logical method to the assessment and diagnosis of disease just as there is to the assessment and diagnosis of nursing problems. I would not step on the doctor's toes.

Read this: http://www.merck.com/mmpe/sec22/ch328/ch328d.html - Diagnostic testing
http://www.merck.com/mmpe/sec14/ch174/ch174d.html - Lyme Disease
http://www.cdc.gov/ncidod/dvbid/lyme/index.htm - Lyme Disease home page at the CDC
- http://www.cdc.gov/ncidod/dvbid/lyme/ld_humandisease_diagnosis.htm - diagnosis
[*]http://www.merck.com/mmpe/sec11/ch142/ch142b.html - Acute Leukemia
[*]http://www.cancer.gov/cancertopics/wyntk/leukemia - What You Need To Know About Leukemia
- http://www.cancer.gov/cancertopics/wyntk/leukemia/page8 - how it is diagnosed

fabiusgile · Oct 31, 2008

My pt was discharged today with w/ 3 antibiotics and a consult with hematology infectious disease and his PCP... I just thought it was interesting never have seen such a low WBC.I had no intention of stepping on his toes we discussed what was going on with him in post conference as a group. This was the first patient I have had where they didn't know what was going on. Find the whole situation interesting. I had looked up lyme dx. before clinical tonight gonna check out the links for cancer that u sent me ty daytonite always a pleasure

Daytonite, BSN, RN · Oct 31, 2008

aren't cases like this intriguing? you have to feel sorry for the poor patient. sometimes medicine doesn't have all the answers. i recall we had a fella who was continually admitted for gi bleeding and over a one year period we calculated from his medical record that he had had 90+ units of blood transfused as both an inpatient and outpatient! they scoped and x-rayed this man and even took him to surgery. they were never able to find where he was bleeding. he eventually died, but i can't remember why. we also had one of the very early aids patients. no one knew what was going on but he wasn't getting better like he was supposed to. in his case it was a new disease that was being discovered. sometimes these things happen. this, i think, is why there will never be robotized medical care. as much as they try to standardize care, they still have to make allowances for cases like this that do happen.

fabiusgile · Oct 31, 2008

It's a whole different feeling when your taking care of someone and you don't know whats going on with them. Must have been interesting dealing with an early case of AIDS

hypocaffeinemia, BSN, RN · Oct 31, 2008

My pt was admitted tues night w/ a fever of 105 and syncop episodes and neck and back aches. He is a 67 year old M. He owns a tree farm and a dozen bee hives. Where running all kinds of blood tests on him Hep, Lyme and some others.
His labs have me banging my head against the wall.
WBC 2
rBC 5.36
HGB 16.1
HCT 46
Platelet 47
WBC diff
Myelocyte 1
Metamyelocyte 2
Neutrophils 33
Atypical lymph 9
Iron studies were all low (TIBC)
AST 1.4
ALT 79
Cal 8.2
I understand the liver funct and the platelets is probably do to the fact he makes his own wine and drinks 2-3 glasses a day. But I can't make sense of the WBC. The Dr. are leaning towards lyme. But I don't htink lyme would cause a low WBC... would leukemia make sense if lyme test is (-)??

Are you sure you're not confusing Leukemia with leukopenia?

Daytonite, BSN, RN · Oct 31, 2008

it's a whole different feeling when your taking care of someone and you don't know whats going on with them. must have been interesting dealing with an early case of aids

you feel a lot of compassion for them because if you have time to listen to them talk about their frustration you can't help but be affected by it.

first aids patient, yes. . .the jig was up when the patient was put on a trial of azt. it's funny when i think about it today. we kept it in the narcotic drawer and had to sign out every capsule because it was an experimental drug at the time. people were going nuts trying to look the drug up. someone finally put two and two together. well, you would have thought an a-bomb was dropped. suddenly, people wanted to gown and glove when they were around him. the food that his family was putting in the fridge in our pantry was suddenly isolated on its own shelf and staff food was no longer kept there (which it was never supposed to be anyway). the staff was scared of catching aids from him and some people refused to be his caregiver. it was like leprosy must have been back in biblical times. i imagine that there will be something similar during your career too since new discoveries are always coming along. look at this asian flu thing a few years ago with people going around with masks on in public.