NU 246 (EXAM 2)-BONE MARROW TRANSPLANT
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- NSG CARE FOR PT WITH BONE MARROW TRANSPLANT
-
FIGHT OF THEIR LIFE
-PT AT RISK FOR INFECTION/SEPTIC SHOCK/NEUTROPENIA
-AT RISK FOR BLEEDING/THROMBOCYTOPENIA
-PT FATIGUE/ANEMIA
-SKIN RXN,ALOPECIA,ANOREXIA,CACHEXIA(WASTING OF PROTEIN MASS) - ONCOLOGICAL EMERGENCIES
-
1.OBSTRUCTIVE
2.METABOLIC
3.CARDIAC TOXICITIES - WHY SHOULD U CAUTION PTS TAKING HERBAL MEDS?
- WILL INTERFER W/ CHEMO TXT
- BIOTHERAPY (BRM)
-
BIOLOGIC RESPONSE MODIFIERS
-ALTERS IMMUNE RELATIONSHIP
-BOOSTS IMMUNE SYS - MONOCLONAL ANTIBODIES
-
CYTOKINES-INTERFERON
-INTERLEUKINS - HPPH
-
NEW DRUG*
PT PHOTOSENSITIVE FOR 5-7 DAYS - S/E OF PHOTOFRIN
-
PT PHOTOSENSITIVE TO SUN (30-60 DAYS)
-COVER COMPLETELY !
-PT CAN GET SEVERE BLISTERS,REDNESS
-PT MUST WEAR SUNGLASSES AND GARB AT NIGHT
-AFTER 1 MONTH-PT TESTED FOR DEGREE OF PHOTOSENSITIVITY -
LASER
-ADVERSE EFFECT
-USED W/ -
GIVEN 3 DAYS LATER
AFTER PHOTOFRIN KILLS CANCER CELLS
S/E:SWELLING (WILL GO AWAY)
USED WITH MESOTHYLOMA,ESOPHAGEAL,SKIN CANCERS - PDT
-
PHOTODYNAMIC THERAPY
**PHOTOFRIN**-DRUG GIVEN IV
-A LIGHT SENSITIVE DRUG THAT CANCER CELLS HOLD ON TO FOR A LONG TIME - PBSCT
-
-PERIPHERAL BLOOD STEM CELL TRANSPLANT
-DONE OUTPATIENT
-APHERESIS - WHAT MIGHT HAPPEN TO PT AFTER BONE MARROW TRANSPLANT?
-
PT MAY GET PNEUMOCYSTITIS OR CMV
-ANY WOUND,TEAR IN MEMBRANE,ETC.CAN GIVE PT INFECTION
-PT MAY NEED UP TO 115 BLD TRANFUSIONS
-AFTER PT GOES HOME-PT CAN GET GVHD
(GRAFT VS HOST DISEASE) - WHEN CAN PT WITH BONE MARROW TRANSPLANT GO HOME?
- ONCE WBC'S ABOVE 1,000
- WHICH MEDS GIVEN TO PT W/ BONE MARROW TRANSPLANT?
-
1.FILGRASTIN (NEUPOGEN)
2.OPRELUKIN (NEUMGEA)
3.ERTHROPOEITIN (PROCRIT) - PT MAY BECOME__ AFTER BONE MARROW TRANSPLANT
-
1.PANCYTOPENIC
2.RISK FOR INFECTION
3.RISK FOR INJURY/BLEEDING - MARROW GIVEN IV (NO FILTER)
-
TAKES 2-4 WEEKS BEFORE THEY START MAKING CELLS
1ST-RBC'S
2ND-PLATELETS
3RD-RBC'S -
RECIPIENT
-BEST IF AGE__
-WILL UNDERGO__ -
UNDER AGE 50
-WILL UNDERGO IMMUNOSUPRESSIVE THERAPY
-CHEMO/WHOLE BODY RADIATION
-MARROW GIVEN IV (NO FILTER) - DONOR
-
-AUTOGRAPH (SELF)
-ALLOGRAPH (FROM SOMEONE ELSE) - CURATIVE
- REPLACES AILING MARROW BY NORMALLY FUNCTIONING STEM CELLS FROM A HEALTHY DONOR
- RESCUE TECHNIQUE
- APHERESIS-PREVENTS BONE MARROW SUPPRESSION