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Polycythemia Vera NCLEX Review

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A quick review of Polycythemia Vera  (By: AllNursingNotes)

What is Polycythemia Vera?

Polycythemia Vera is a blood disorder that leads to an abnormal increase in the number of blood cells (more primarily red blood cells).

What are the SYMPTOMS?

Here are some of the symptoms in the patient as the disease progresses:

  • Shortness of breath
  • Breathing difficulty
  • Numbness, tingling, burning
  • Fatigue
  • Headache
  • Dizziness
  • Itchiness

With Polycythemia Vera, there is a mutation in the bone marrow cell that causes a problems with the blood cell production.   In a patient with polycythemia vera, the mechanism your body uses to control the production of blood cells becomes impaired, and your bone marrow makes too many of some blood cells.

Therefore the patients can have complications such as:

  • Blood clots. Polycythemia vera causes your blood to be thicker than normal, which can slow the rate of blood flow through your veins and arteries. Increased blood thickness and decreased blood flow, as well as abnormalities in your platelets, increase your risk of blood clots.

Blood clots can cause

  1. a stroke
  2. a heart attack
  3. blockage of an artery in your lungs (pulmonary embolism)
  4. vein deep within a muscle (deep vein thrombosis).
  • Enlarged spleen (splenomegaly). Your spleen helps your body fight infection and filter unwanted material, such as old or damaged blood cells.  The increased number of blood cells caused by polycythemia vera makes your spleen work harder than normal, which causes it to enlarge.

How do we diagnose this patient?

We would usually do a Blood test for this patient:

The Blood Test would usually show:

INCREASE  ↑

  • An increase in the number of red blood cells
  • Elevated hematocrit measurement
  • Elevated levels of hemoglobin the iron-rich protein in red blood cells that carries oxygen.

DECREASE ↓

  • Very low levels of erythropoietin (EPO), a hormone that stimulates bone marrow to produce new red blood cells.

TREATMENTS:

Phlebotomy

When treating this patient with this method, we need to be careful and withdraw only about 250 to 500 cc of blood daily or every other day until a hematocrit between 0.4 and 0.45 (40% and 45%) is obtained.

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