questions!

Silverdragon102, BSN · Aug 21, 2009

What sort of ideas have you come up with?

wjddnjs · Aug 21, 2009

I thought the antibiotics are to be given because the patient's having symptoms of infection like the fever and diarrhoea. am I on the right track?

Silverdragon102, BSN · Aug 21, 2009

In my opinion you are on the right track but also think about the fact that he has just had chemo. Think about what Chemo does to the body and how the patient is educated

JJRN09 · Aug 22, 2009

I would think about what some Chemo can do to the mouth since he had recent dental work.

NurseKitten, MSN, RN · Aug 22, 2009

What does chemo do to the body, specifically the body's immunity?

So if you were his nurse, giving the IV's what would you have to make ABSOLUTELY certain was done to prevent further complications?

Daytonite, BSN, RN · Aug 23, 2009

this is a problem solving situation and you can use the nursing process to help you solve it. recognize that ordering antibiotics are a medical treatment. doctors would order antibiotics if they had diagnosed an infection.

step 1 assessment - 27-year-old man who was diagnosed with acute myeloid leukaemia and has had chemotherapy. he came to the er with a bleeding gum cavity after a tooth extraction. symptoms include a temperature spike of 39 degree day 10 post chemotherapy, rigors, profuse sweating and two episodes of watery diarrhoea.

step #2 determination of the patient's problem(s) - bleeding, infection, side effects of the chemotherapy drugs, potential side effects of gentamycin

step #3 planning - carry out the physician's orders and give the antibiotic as ordered.

explain why antibiotics are to be given.

the patient had to have been diagnosed by the physician with an infection. symptoms that support this are: temperature of 39 degrees, rigors and the fact that he has had dental work which provides an open site for microbes to enter the body. most dentists would have given antibiotic prophylaxis several days before extracting a tooth because of the possibility of an infection occurring this way and only done this extraction because it was absolutely necessary. the leukemia would have been a risk factor for an infection and bleeding to occur as a result of the tooth extraction.

chemotherapy kills off rapidly growing cells. cancer cells are rapidly growing cells. however, there are some normal cells of the body that are also rapidly growing such as mucus cells and hair cells and they are also destroyed by the therapeutic agent. mucus cells line the entire gi and respiratory tract. the diarrhea is due to the chemotherapy because the mucus cells line the gi tract and have been destroyed by the chemotherapeutic agent resulting in irritation of the lining of the intestines and colon. result: diarrhea. when the chemo is stopped the mucus cells will regenerate and the diarrhea will stop.

revise the nursing responsibilities involved in the iv administration of medications

see post #5 on

https://allnurses.com/nursing-student-assistance/any-good-iv-127657.html

-

any good iv therapy or nursing procedure web sites

for iv procedures.

for your presentation i would recommend that you read about:

myeloid leukaemia

infection/sepsis and the potential complications of dental extractions

http://www.merck.com/mmpe/sec08/ch096/ch096d.html
- post extraction problems
http://www.merck.com/mmpe/sec08/ch096/ch096e.html
- toothache and infection
http://www.merck.com/mmpe/sec06/ch068/ch068a.html
- sepsis and septic shock

gentamycin (it has specific side effects connected with its administration)

http://www.drugs.com/pro/gentamicin-injection.html
- gentamycin sulfate injection

wjddnjs · Aug 23, 2009

When the question asks about the nurses' responsibilities involved in the IV administration, does that mean the procedure of the administration of the drug??

Daytonite, BSN, RN · Aug 23, 2009

Do you have a dictionary? If you look up the word responsibility it tells you it involves accountability, obligation, duties. What (duties) will you have to do in order to administer the drug? So, yes, it is the procedure and the nursing actions you will perform in order to give the Gentamycin.