Description
An adult patient with a chronic myelogenous leukemia sits down with you to discuss his questions and concerns about his upcoming bone marrow transplant. He has already received some educational materials and participated in a family conference during which health team members described the procedure and potential complications. He has been told that he has a risk of graft rejection or graft versus host disease (GVHD), but he does not understand the distinction (Chapter 12, Learning Objectives 1, 2, 10, 11).
What are the similarities between graft versus host disease and graft rejection?
What are the pathophysiologic differences between graft versus host disease and graft rejection?
How would these differences be manifested clinically?
Studies have shown a protective effect of mild to moderate GVHD in cancer patients who have had a bone marrow transplant. Based on your understanding, can you explain these findings?
Ed Beatty is a 52-year-old client with a history of chronic renal insufficiency who presents to the medical clinic reporting a severe sore throat. He is diagnosed with a streptococcal pharyngitis. He is informed by the primary care provider that he will be treated with an IM injection of penicillin G. (Learning Objectives 2, 3, and 9)
1. What information should be collected from Mr. Beatty before the administration of the penicillin G?
2. Mr. Beatty asks why he cannot receive the medication in oral form. How should the nurse respond?
3. Describe the equipment that the nurse should have available before administering the medication to Mr. Beatty. Why is this necessary?
4. After receiving the penicillin G, Mr. Beatty experiences cardiac arrest. He is successfully resuscitated. Discuss the potential causes of the cardiac arrest.
5. Mr. Beatty has recovered from the arrest and the nurse is preparing his discharge teaching. What information related to the penicillin G should the nurse include?
