Page 221 - Critical Care Notes

4223_Tab07_199-215 03/09/14 4:25 PM Page 215

215
■ Pulmonary complications: A common problem; causes of lung injury or
pneumonitis possibly infection, chemical, bleeding, or idiopathic
Management
■ Provide emotional support to patient and family.
■ Perform good hand washing and aseptic technique.
■ Use reverse isolation procedures.
■ Monitor CBC and BMP laboratory tests frequently.
■ Provide frequent oral care.
■ Assess for signs and symptoms of bleeding.
■ Monitor vital signs every 4 hr or more frequently if needed.
■ Administer immunosuppressive drugs as ordered.
■ Consider IV or enteral nutritional support.
Coagulation

Lab Conventional SI Units
Activated coagulation time (ACT) 90–130 sec 90–130 sec
Activated partial thromboplastin 25–39 sec 25–39 sec
time (aPTT) (>70 sec)
Bleeding time (>14 min) 2–7 min 2–7 min
Fibrinogen (<80 mg/dL) 200–400 mg/dL 2–4 g/L
International normalized ratio Normal: <2 <2
(INR) (>5) Target therapeutic: 2–3 2–3
Plasminogen 80%–120% of normal 80%–120%
of normal
Plateelets (<20,000; >1,000,000) 150,000–450,000/mm 3 150–450 ’
109/L
Prothrombin time (PT) (>27 sec) 10–13 sec 10–13 sec
Thrombin time 11–15 sec 11–15 sec

TNM Staging of Cancer

T: Tumor Size N: Nodes Involved M: Metastasis
T1 ........................Small N0 ......No involvement M0........................None
T2 or T3 ..........Medium N1–N3...........Moderate M1...............Metastasis
T4.........................Large N4 .................Extensive

HEMA/
ONCO