Case study Help Please!

[Neats, BSN]

OK psudo client has the following:

Lab values

Urine Protein +2

Bilirubin 5.5

MPV 7.7L

MCV 112.4H

MCH 38.2

Hct 26.5L

Hgb 9.0L

RBC 2.36L

Lymphocytes 18L

Rx

Morphine 30mg PO TID

Hydrea 500mg Qam PO

Zithromax 250mg q am PO

I am thinking the mystery illness could be sickle cell or lukemia, not sure.

I am looking for any feedback. This is not a real person just a case study to find a mystery illness. Thank you all in advance for your replies.

[leslie :-D]

why are you thinking sickle cell?

because of the blood counts?

the hydrea will cause that too...

leslie

[UM Review RN, ASN, RN]

They use Zithromax for leukemia and sickle cell? hmmm...

[Neats, BSN]

I forgot to add the O2 sat is 88.

This is why I was thinking of the 2 but I need experience nurses to assist me. Thanks

[Daytonite, BSN, RN]

liver cancer?

[leslie :-D]

OK psudo client has the following:

Lab values

Urine Protein +2

Bilirubin 5.5

MPV 7.7L

MCV 112.4H

MCH 38.2

Hct 26.5L

Hgb 9.0L

RBC 2.36L

Lymphocytes 18L

Rx

Morphine 30mg PO TID

Hydrea 500mg Qam PO

Zithromax 250mg q am PO

I am thinking the mystery illness could be sickle cell or lukemia, not sure.

I am looking for any feedback. This is not a real person just a case study to find a mystery illness. Thank you all in advance for your replies.

i'm thinking more towards one of the leukemias/myelomas...specifically because of the lymphocytes being 18k.

bilirubin levels would be increased if the anemias are hemolytic, or, are being destroyed prematurely by other means.

with either sickle cell or leukemia, infections are very common.

but if they were looking for sickle cell, it wouldn't be by rbc alone, rather along w/blood smears and hgb variants.

and although leukemia originates from the bone marrow, tumor cells also tend to settle in areas where there are groups of lymph nodes/glands.

i vote for leukemia.

leslie