NURSING CARE FOR

PANSITOPENIA
Faculty of Nursing-Unissula
 LEARNING OBJECTIVES
• Definition
• Etiology
• Sign & Symptoms
• Diagnostic test
• Nursing Assessment
• Nursing Diagnosis
• Nursing Intervention
 DEFINITION

• Pancytopenia is an important hematological problem encountered in our day-

to-day clinical practice. It is a decrease in all three cellular elements of
peripheral blood leading to anemia, eucopenia and thrombocytopenia
(Hayat, Balokh, Syaikh, 2014). Aplastic anemia (hypoplastic) is defined as
pancytopenia caused by bone marrow aplasia (hoffbbrand et al, 2005)
• Its combination of anemia, leukopenia and thrombocytopenia (HB<10 gr/dL;
leukocyte count<4000/ul; platelet count <150,000 uL)
 ETIOLOGY

• Kanker yang menghancurkan sel sumsum tulang

• kegagalan membuat sel punca yang berubah menjadi sel
darah
• fibrosis atau jaringan parut pada sel sumsum tulang
• sistem kekebalan menghancurkan sel-sel sumsum tulang
yang sehat
• penekanan fungsi sumsum tulang karena penyakit atau
obat-obatan (bone marrow failure & bone arrow infiltration)
• Radiotherapy
• SLE
 SIGN & SYMPTOMS
• At the symptoms of anemia was found pale, tachycardia, heart
murmur, fatigue, dizziness, etc.
• Sometimes accompanied by a deficiency of platelets and white
blood cells. Platelet deficiency can result in ecchymosis and
petechiae, epistaxis, gastrointestinal bleeding, urinary tract bleeding,
bleeding the central nervous system.
• While a deficiency of white blood cells makes the body susceptible to
infection.
 DIAGNOSTIC TEST
• Px Darah Rutin: RBC, WBC,
• Bone marrow aspiration
• Biopsy
 NURSING ASSESSMENT

• History: Bleeding, anemia symptomp, infectons, drugs or chemicals

• Physical exam: Petechie, ecchymosis, retinal bleeding, Pallor, Fever and
other signs of infection, lymphadenomegaly & splenomegaly
 NURSING DIAGNOSIS
• Altered Tissue Perfusion related to a decrease in cellular components
required for the delivery of oxygen / nutrients to the cells.

Goal: indicates adequate perfusion

Expected outcomes:
Vital signs are stable.
• Pink mucous membranes.
• Capillary refill.
• Adequate urine output.
 NURSING INTERVENTION
• Intervention and Rationale :

1) Measure vital signs, observation capillary refill, color of skin / mucous membranes, nail beds.
R /: Provides information about the adequacy of tissue perfusion and help needs intervention.

2) Auscultation of breath sounds.

R /: Dyspnea, gurgling shows CHF as long heart strain / compensatory increase in cardiac output.

3) Observation complaints of chest pain, palpitations.

R /: Ischemia cell, affecting myocardial tissue / potential risk of infarction.

4) Evaluation slowed verbal response, agitation, memory impairment, confusion.

R /: May indicate cerebral perfusion disturbances due to hypoxia

5) Evaluation of complaints of cold, keep the ambient temperature and the body to keep warm.
R /: vasoconstriction (to vital organs) lowers peripheral circulation.

Collaboration
6) Observation results of laboratory tests Complete blood.
R /: Identify deficiencies and needs treatment / response to therapy.

7) Provide a complete blood transfusion / packed as indicated.

R /: Increase the number of oxygen-carrying cells, improve the deficiency to reduce the risk of bleeding.

8) Give oxygen as indicated.

R /: Maximizing oxygen transport to the tissues.

9) Prepare the surgical intervention as indicated.

R /: Bone marrow transplant performed on bone marrow failure / aplastic anemia.
 ASSIGNMENT
• Kindly find others nursing diagnoses that have possibility related to
pansitopenia, including the outcomes & interventions.
• Upload to simakademik, max of 3 days after this session.