Page 426 - Critical Care Nursing Demystified

Chapter 9 CARE OF THE PATIENT WITH CRITICAL HEMATOLOGIC NEEDS 411

Other Tests
There are other tests that can be used to help monitor patients with acute
hemolytic anemia. These include tests for iron and its storage and are listed in
Table 9–4.

4 TABLE 9–4 Other Tests for the Presence of Iron
Test What It Shows Normal Values
Serum iron (Fe) Decreases with serum iron concentration 75–150 μg/dL
Serum ferritin Highly sensitive test for total body iron 30–300 ng/mL
stores
Decreased in iron-deficiency anemias
Serum transferring Production increased with low iron 250–460 μg/dL
(total iron-binding stores as this is transport protein
capacity)

Diagnostic Tests

ECG/EKG – Electrocardiogram to check for MI, which can be caused in
severe anemias. Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.158.117] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.
CT scan – Can help locate source of sepsis.
Bone marrow aspiration/biopsy – Microscopic study of cells growing in bone
marrow. This study is done by the physician with the nurse assisting. The
physician inserts a coring needle for an aspiration and a special larger needle
for an aspiration.

H ? How to Do It—Assisting With a Bone

o
o I
s
w t
As
o D
t—
Marrow Aspiratio
Marrow Aspiration
1. Check that a consent form is signed.
1 . Check that a c onsent f orm is si g ned .
2. Identify the patient with at least two qualifiers and perform time-out.
the patient with at least tw
2.
o qu
Identi
fy
a
edur
ulation stu
g
al c
a
o
.

d
3. Monitor preprocedural coagulation studies to determine if the patient is sub-
3
Monit
o
c
epr
o
r pr
j ject to bleeding.
bl
di
4. Assess the patient’s knowledge of what to expect during the study and as far as
the results of the study. It will take approximately 30 minutes.