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Chapter 22 |
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Lucia Hernandez is a 16-year-old who is undergoing treatment for acute lymphocytic leukemia. Her entire family relocated to the United States from Mexico four years ago. The treatment regimen has caused her to lose her hair, gain weight, and become very susceptible to infection. Her mother reports that she has very labile moods, with a defiant, angry attitude. She has refused visits from her school friends, falling behind in her studies. Currently, she is admitted to the hospital with a temperature of 101°F, blood pressure 110/60, apical pulse of 90, and respirations of 24 per minute. Her skin is pale, with poor turgor. The nurse notes a dry, nonproductive cough. Upon auscultation, decreased breath sounds are noted in both lower lobes of her lungs. A stat CBC (complete blood count) is ordered, with the following results:
WBC 1700/μl
Band neutrophils 8%
Segmented neutrophils 35%
Lymphocytes 12%
Hemoglobin 9.0 g/dl
Hematocrit 26%
Platelet count 19,000/μl
The nursing staff is concerned because Lucia is at significant risk for infection, yet large groups of family members and friends are visiting at all hours of the day and night. The situation is further complicated by the fact that most of Lucia's family members speak very little English. Fill in the appropriate elements of the care plan for this client in the boxes below.
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