Test Run

POLYCYTHEMIA:

NURSING CARE PLAN

Recognizing, Managing, and

Educating Patients

PATHOPHYSIOLOGY OF

POLYCYTHEMIA

• Increased RBC mass: Hyperviscosity
• Primary: JAK2 mutation
(Polycythemia Vera)
• Secondary: Hypoxia response, high
EPO
• Complications: Thrombosis,
splenomegaly

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A patient with a known history of Polycythemia Vera presents with increased fatigue, pruritus, and an enlarged spleen. Laboratory tests show significantly elevated red blood cell mass, hematocrit, and hemoglobin levels. The patient's condition is primarily associated with a mutation in the ​

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gene.

CLINICAL MANIFESTATIONS

• Symptoms:
- Headache, dizziness, blurred
vision
- Pruritus (itching), especially after
warm baths
- Ruddy complexion, hypertension
- Splenomegaly (enlarged spleen)

LABS AND DIAGNOSTICS

• CBC: Elevated RBC, hemoglobin,
hematocrit
• EPO levels: Low in primary, high in
secondary
• JAK2 Mutation Test: Positive in
Polycythemia Vera
• Bone Marrow Biopsy: Hypercellular
marrow

NURSING CARE PLAN

• Assessment: Recognize symptoms, lab
findings
• Nursing Diagnosis: Risk for ineffective
tissue perfusion, fatigue
• Goals:
- Short-term: Symptom relief, reduce
hematocrit
- Long-term: Prevent complications,
patient education

NURSING INTERVENTIONS

• Phlebotomy: Reduce blood viscosity
• Hydration: Dilute blood, prevent clots
• Medications:
- Hydroxyurea: Reduce RBC production
- Low-dose Aspirin: Prevent thrombosis
- Antihistamines: Relieve itching
- Allopurinol: Prevent gout
- Ruxolitinib: Target JAK2 mutation

PATIENT EDUCATION &

EVALUATION

• Patient Education:
- Importance of regular monitoring and
check-ups
- Lifestyle changes: Hydration, no
smoking
- Medication adherence
• Evaluation:
- Assess symptom relief, lab results
- Monitor for complications