Leukemia Case Study (60 min)
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Study Tools For Leukemia Case Study (60 min)
Outline
Mr. Devito is a 48-year-old male who presents to his Primary Care Provider with left upper abdominal pain and complaints of weakness and fatigue. The nurse immediately notes how pale his skin is. A full set of vital signs reveals the following:
HR 82 bpm
BP 142/90 mmHg
RR 16 bpm
SpO2 94% on Room Air
Temp 101.0°F
What furtner nursing assessments would you perform at this time?
Upon further assessment, the nurse notes a palpable mass in the left upper quadrant, possibly an enlarged spleen, that is tender on palpation. The nurse also notes petechiae and bruising to the patient’s arms and legs. When questioned, the patient says “I seem to bruise so easily these days”. The patient’s lungs have diffuse crackles, heart sounds S1 and S2 present with no murmurs. The patient also reports a slight headache.
What laboratory or diagnostic tests do you anticipate the provider ordering?
The provider orders a complete blood count, chemistry panel, and chest x-ray. The chest x-ray shows the patient has a slight pneumonia. He is sent home with a course of antibiotics while awaiting the test results.
The next day, the lab results show the following:
RBC 4.2 BUN 22
Hgb 8.4 Cr 0.9
Hct 25.2 K 3.9
WBC 144,000 Na 148
Plt 40,000 Ca 7.6
Based on the above lab results, what should the nurse be most concerned about?
What do you believe may be going on, physiologically, with Mr. Devito?
What further diagnostic testing should be performed to confirm a diagnosis?
How would you explain this to the patient’s wife?
Mr. Devito will be started on high-dose chemotherapy.
What education topics should be included in teaching for Mr. Devito and his wife?
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Nursing Case Studies
This nursing case study course is designed to help nursing students build critical thinking. Each case study was written by experienced nurses with first hand knowledge of the “real-world” disease process. To help you increase your nursing clinical judgement (critical thinking), each case study includes answers laid out by Blooms Taxonomy to help you see that you are progressing to clinical analysis.
We encourage you to read the case study and really through the “critical thinking checks” as this is where the real learning occurs. If you get tripped up by a specific question, no worries, just dig into an associated lesson on the topic and reinforce your understanding. In the end, that is what nursing case studies are all about – growing in your clinical judgement.
