MYELODYSPLASTIC SYNDROME

Is a group of blood disorders characterized by abnormal-appearing bone marrow and cytopenia Characterized by low red blood cells, low white blood cell count with a tendency to infection, and low platelet count with bleeding problems May progress and transform into acute myelogenous leukemia formerly known as "preleukemia"

MDS is a stem cell disorder in which stem cells fail to reproduce and differentiate into the various types of blood cells. The genetic components of stem cells are altered. The bone marrow loses its ability to produce normal blood cells, instead producing abnormal (dysplastic) cells. With significant alterations, leukemia (proliferation of abnormal white blood cells)may develop in people with MDS.

 IDIOPHATIC MDS Primarily affects older adults Men have a slightly higher incidence of the disorder than women
RISK FACTOR TO SECONDARY MDS: Cigarette smoke Exposure to environmental toxins Radiation Radiation therapy (chemotherapy)

The survival rates range from six months to a number of years for the different subtypes of MDS. Death is usually due to bleeding or infection. Transformation to AML occurs in up to 40% of patients and carries a poor prognosis.

TREATMENTS Iron chelation therapy Antibiotic therapy Azacitidine (Vidaza)

NSG INTERVENTION
Monitor vital signs Encourage 8-10 hours of sleepn at night Instruct the client not to smoke

POLYCYTHEMIA
Is a condition that results in an increased level of circulating red blood cells in the bloodstream. People with Increase in hematocrit, hemoglobin, or red blood cell count above the normal limits.

Polycythemia can be divided into two categories; primary and secondary.

Primary polycythemia: In primary polycythemia the increase in red blood cells is due to inherent problems in the process of red blood cell production. Secondary polycythemia: Secondary polycythemia generally occurs as a response to other factors or underlying conditions that promote red blood cell production.

 Red cell production (erythropoiesis) takes place in the bone marrow through a complex sequence of tightly regulated steps. The main regulator of the red cell production is the hormone erythropoetin (EPO).

 Erythropoietin secretion is up-regulated in response to low oxygen levels in the blood. More oxygen can be carried to tissues when erythropoietin stimulates red blood cell production in the bone marrow to compensate for the hypoxia.

RISK FACTORS
Smoking Chronic Carbon Monoxide Exposure People with genetic mutations and familial types of polycythemia

TREATMENTS
Quit smoking Phlebotomy Hydroxyurea (Hydrea)

NORMAL

LYMPHEDEMA
Also known as lymphatic obstruction, is a condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system. The lymphatic system returns the intersitial fluid to the thoracic duct and then to the bloodstream, where it is recirculated back to the tissues.

 Maybe primary or secondary disorder: PRIMARY LYMPHEDEMA - is uncommon and may be associated with a genetic disorder such as turner syndrome SECONDARY LYMPHEDEMA- is an acquired condition resulting from damage, obstruction, or removal of lymphatic vessels.

 Most common worldwide cause of Secondary Lymphedema is Filariasis Reccurent episodes of bacterial lymphangitis Obstruction of lymph vessels by tumors Surgical or radiation tx for breast cancer

TREATMENTS
Foot care Wear elastic stockings The foot of the bed is raised by 15-20 degrees at night to promote lymph flow