I was writing b/c i had a few questions for you all! I am a new grad CCU RN and today (my very first day off orientation) I ended up w/ an off service pt and inmate but that is another story!!! The patient came down from the oncology unit to us b/c of respiratory distress. Anyhow, after the patient was stabilized, the MD's still wanted the chemo....which is all fine and I understand that a pt does not want to miss a day of chemo. I had to premedicate the patient and one of the wonderful onc nurses came down to hang the chemo for me....I left today with some questions though and was hoping you could answer them for me.
The patient had AML and had wbc count of 1 in the AM and then .5 six hrs later. Her H/H was 10.8 and 29.5 She was premedicated w/ Zofran, Dexamethosone, and another I cannot remember. She also had to have bicarb running @100. Why bicarb? And what is the rationale behind the premedications? What are u preventing. She was getting two different chemo bags....I meant to write down the names, they didnt sound familiar to me though (not that I know many of them anyhow).
She also had a lot of vaginal bleeding. She was passing alot silver dollar to slightly bigger size clots. Is this common w/ this type of patient? Sorry...these may be dumb questions...I just left today from work w/ alot of unanswered questions.
In addition, I needed to check her urine pH and keep it greater than 7.0. Why is the rationale behind this?
Oh and one more question..... she also needed platlets, count of 8 got 1 u and went up to 21 but she started to have rxn during the transfusion so i shut it off after bout half the way through (what a day!!!)) is this seen often w/ aml patients?
thansk so much for ur help!!!!
-curious new CCU RN