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    1 Case: Polycythemia Rubra Vera (PRV) or Polycthemia Vera (PV)

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    fleur harrison
    The patient, a 62-year-old male smoker and drinker, presented with fatigue, pruritus, edema, and rashes. Lab work showed elevated red blood cell count, hemoglobin, and hematocrit consistent with polycythemia vera. A JAK2 mutation was found and bone marrow biopsy showed hypercellularity, confirming the diagnosis. Treatment included phlebotomy, hydroxyurea, aspirin, and allopurinol. The patient's symptoms and labs improved and he was discharged with medications and follow up planned.

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    1 Case: Polycythemia Rubra Vera (PRV) or Polycthemia Vera (PV)

    Uploaded by

    fleur harrison
    26 views4 pages
    The patient, a 62-year-old male smoker and drinker, presented with fatigue, pruritus, edema, and rashes. Lab work showed elevated red blood cell count, hemoglobin, and hematocrit consistent with polycythemia vera. A JAK2 mutation was found and bone marrow biopsy showed hypercellularity, confirming the diagnosis. Treatment included phlebotomy, hydroxyurea, aspirin, and allopurinol. The patient's symptoms and labs improved and he was discharged with medications and follow up planned.

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    CASE-1-PV

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    The patient, a 62-year-old male smoker and drinker, presented with fatigue, pruritus, edema, and rashes. Lab work showed elevated red blood cell count, hemoglobin, and hematocrit consistent with polycythemia vera. A JAK2 mutation was found and bone marrow biopsy showed hypercellularity, confirming the diagnosis. Treatment included phlebotomy, hydroxyurea, aspirin, and allopurinol. The patient's symptoms and labs improved and he was discharged with medications and follow up planned.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    26 views4 pages

    1 Case: Polycythemia Rubra Vera (PRV) or Polycthemia Vera (PV)

    Uploaded by

    fleur harrison
    The patient, a 62-year-old male smoker and drinker, presented with fatigue, pruritus, edema, and rashes. Lab work showed elevated red blood cell count, hemoglobin, and hematocrit consistent with polycythemia vera. A JAK2 mutation was found and bone marrow biopsy showed hypercellularity, confirming the diagnosis. Treatment included phlebotomy, hydroxyurea, aspirin, and allopurinol. The patient's symptoms and labs improved and he was discharged with medications and follow up planned.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 4

    ST.

    LUKE’S COLLEGE OF NURSING


    1st Semester
    School Year: 2020-2021
    LEVEL 3 RLE
    NCM 112

    1ST CASE: POLYCYTHEMIA RUBRA VERA (PRV) OR POLYCTHEMIA VERA (PV)

    Day 1: The patient presented in May 2020 at age 62 with a two-year history of fatigue and pruritus of his extremities. He smoked
    one pack of cigarettes per day as he had for 25 years and had about five to six alcoholic drinks daily. VS: BP 160/100, PR 75, RR
    18, T 37.8. Height is 183 cms and weight is 85kgs.

    Presence of pruritic rashes on all extremities, back, abdomen and face, edema on all extremities and erythromelalgia
    COMPLETE BLOOD COUNT
    Hemoglobin 21.9 g/dL (14.0–18.0)
    RBC 7.96 × 106/µL (4.50–6.00)
    MCV fL 90.1 (80.0–99.0)
    WBC 10.1 × 103/µL (4.5–10.8)
    Neutrophils 71%
    Lymphocytes 18%
    Monocytes 8%
    Eosinophils 2%
    Basophils 1%
    platelets 154 × 103/µL
    Reticulocytes 5 percent

    Patient was admitted in the Hematology ward with working diagnosis of Polycythemia Vera. The following orders was made by
    her Attending Physician:
    • Start IVF of PNSS 1 liter to run for 60cc/hr
    • For Phlebotomy at 3pm, prepare materials and secure consent
    • For CT scan of whole abdomen with contrast
    • Blood tests: EPO level and repeat CBC post phlebotomy
    • Medications
    o Give aspirin 80 mg 1 tablet daily
    o Cetirizine 10mg 1 tablet at bedtime daily
    Day 2:
    • CT scan of abdomen revealed Splenomegaly
    • EPO level is subnormal
    • For bone marrow biopsy, prepare materials and secure consent
    • For genetic testing of JAK 2 mutation
    • Additional Medications
    o Hydroxyurea 500mg 2 tablets daily
    o Ranitidine 150 mg 1 tablet twice daily
    o Allopurinol 100mg 1 tablet twice daily
    Day 3:
    • Genetic testing result is positive for JAK 2 mutation
    • Bone marrow biopsy revealed hypercellular bone marrow
    • IVF discontinued
    • Repeat CBC
    o Hgb 13g/dL
    o Hct 40%
    o RBC 4M/µL
    o WBC 7.8 X 10³/µL
    o Platelet 154 X 10³/µL
    • Reticulocytes 3%

    Day 4:
    • Patient discharged
    o FINAL DIAGNOSIS: Absolute Primary Polycythemia Vera
    o HOME MEDICATIONS:
    ▪ Aspirin 80 mg 1 tablet daily
    ▪ Cetirizine 10mg 1 tablet at bedtime daily
    ▪ Hydroxyurea 500 mg 2 tablets daily
    ▪ Ranitidine 150 mg 1 tablet twice a day
    ▪ Allopurinol 100mg 1 tablet twice daily
    o FOLLOW UP AFTER 4 WEEKS

    LEARNING PACKETS

    I. HISTORY TAKING
    II. PHYSICAL EXAMINATION/CONTRAPTIONS
    III. PATHOPHYSIOLOGY
    IV. DIAGNOSING THE DISEASE
    V. CORRELATE DOCTOR’S ORDER TO LABORATORY RESULTS TO PT’S S/SX (PATHOPHY)
    VI. FORMULATION OF PLAN OF CARE
    VII. FORMULATION OF NURSING DIAGNOSIS
    VIII. NCP
    IX. NURSING SKILLS VIDEO
    X. DRUG STUDY OF MEDICATIONS ON BOARD AND OTHER MEDICATIONS RELATED TO THE DEASE
    XI. ANY SPECIAL PROCEDURE OR OPERATION
    XII. DISCHARGE HEALTH TEACHINGS ABOUT THE DISEASE AND ITS COMPLICATIONS

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