Audio Transcript Auto-generated
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My name is Crystal Dela Cruz and I will be presenting a
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case study about lou who is
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undergoing allergenic hematopoietic stem cell transplant.
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Talking about Lulu is a 50 year old male who works on a family farm.
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He lives with his wife and three Children.
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He was diagnosed with B cell acute lymphoblastic leukemia
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after two cycles of hyper seabed bit in the article
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said therapy and he's about to undergo cycle possible.
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My time of you. Blaine allergenic
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bone marrow transplant.
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His past medical history includes hypertension,
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high cholesterol and osteoarthritis
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preconditioning face for Lou who is undergoing a logistic transplant.
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Ain't the following
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first is to eradicate his leukemia and
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injured smile of suppression with administration of chemotherapy
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which is the cycle of possible mind
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reduce the risk of toner rejection complication or G. V. H. D.
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By receiving time of glow building which is an anti time side globally.
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The conditioning therapy also aims to a blade in
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the marrow to create space for east transplanted donor
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meta poetic stem cells
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and by infusing the donor's stem cells
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will reconcile straight a healthy immune system.
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Also
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we want to achieve
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eradicating his leukemia and that is the graft versus
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host leukemia effect or the graft versus tumor effect.
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Yeah.
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To achieve the aims of treatment means that louis and his family
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needs full participation and a strong commitment to the whole process.
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This also requires a specialist nurse to have a standing
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knowledge and needs to be equipped with advanced exceptional skills
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uh huh.
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As a preparation for the stem
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serve transplant.
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This needs to be done.
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The first thing is to inform and educate lou including the family member
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of the processes and treatment protocols involved
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in the procedure such as possible complications,
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management and supportive care services that are available.
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Also,
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it's very important to coordinate all pre
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transplant work up including blood tests.
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This includes organ function barrow and bacterial screening,
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This tissue matching and cT scans
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to identify any comorbidities that are pre existing.
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This is done to select an appropriate treatment and
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let's say donor selection and reduce potential complications.
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Also, it's very important to talk about
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are educating you and his family about venus access device
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devices in which
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it starts from insertion, the care and the maintenance.
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The role of the nurses doesn't end with
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the bridge transplant phase throughout the process,
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transplant coordinator's needs to provide a high level of care and
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this includes performing safe handling practices during in the station of chemo
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including the care of the sea beds.
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Monitor lose condition post transplant.
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It's very important to identify any potential science of early
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and acute complications and adhere to the best practice nursing interventions
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between the time of the deer and then grab meant. It's very important
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for us to monitor lose blood counts and provide any blood product support if needed,
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administering daniel aside,
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coordinating simulating factor drugs can shorten the time from
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entrepreneur to entrapment and reduced risk of neutropenia fevers,
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potential complications of her math. A poetic stem cells.
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Specifically allergenic includes the following
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have versus host disease, infection or sepsis and malnutrition,
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Crabb vs host disease starts when there's a damage
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that the host tissues due to the conditioning region.
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It releases inflammatory side to side against such
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as tumor across as factor and interleukin one.
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It then activates host androgen presenting cells.
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These ap CS activates
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the natural killer cells that mediate tissue damaging
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and eventually it attacks the epithelial cells of the skin, liver,
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lung and gastrointestinal tract.
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The path of physiology of infection. Sepsis and malnutrition is
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presented on this same slide.
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If we all start with the transplant and with the conditioning regime
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the ablation of the marrow will happen.
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Miles oppression will result from it and follows
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neutropenia and then up invasion of opportunistic pathogens.
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Well then cause infection and if it's untreated
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and systematically it will then result in sepsis.
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Yeah
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on the other hand,
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the conditioning regime will then activate inflammatory side can't
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and it will damage the base of cells.
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This will then release oxidative stress generation of reactive oxygen species
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and
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production. Observer mixing taste which will cause apoptosis.
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It would then
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differentiate from your societies and societies leads the pain and pain can
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lead to an erection and of course we lost all malnutrition.
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Mhm.
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The best practice of a specialist cancer
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nous and care for the following complications will
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be discussed in this light. So for. Gbh it is very important to assess the onset
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of the disease. Uh and delivering supportive care in education,
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pharmacologic prophylaxis measures like cyclosporin
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and michael generate more feel
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metro taxi and other agents
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needs to be administered.
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It is also important to monitor for early signs of acute GBh.
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This is fresh due to the damage epithelial lining of skin
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gi symptoms that includes weight loss, stomach discomfort,
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being nausea, vomiting and diarrhea.
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And if G V.
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H develops, it is very important to provide an evidence based nursing care.
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For instance administration of steroids which is still
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the best in the first line of therapy
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for the management of infection.
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Sepsis is important to provide antibacterial antiviral and
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antifungal prophylaxis infection control measures like handwashing,
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oral hygiene, low bacterial diet, industrial intestinal, the camera,
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the contamination.
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Also to put a patient on protective isolation during the Notre panic face.
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Routine assessment should be done of the vitals, especially the temperature
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and of course make sure to do the appropriate care of the event
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you have
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management of malnutrition is
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I believe for me to treat the source of the condition
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we lose case or american.
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Scientists can be painful and can hinder him for any food intake.
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So pain relief and or a cryotherapy during treatment is
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very important. Routine surveillance of their intake and requirements.
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Any nausea vomiting rate in bible
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anomalies should be given management assessment.
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They need apparent terror nutrition for patients undergoing transplant
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and effectiveness of the nutrition of nutritional support.
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Yeah.
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Uh huh.
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Yeah.
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Allergenic Martha.
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Poetic stem cell transplant is a complex
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process and necessarily a crucial role within
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the multidisciplinary team came for the patients
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and their families undergoing this intense treatment.
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The amount of distress during this time
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is not to be underestimated. It's very important that the continuity of care
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to the patient right from the initial
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treatment up to the transition
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base where they would
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from acute care to long term follow up clinics
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is very important.
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Nurses are an advocate out the transplant and
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often access motivating force support and advising,
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as well as supplying
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all the care for the patient.
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Experienced nurses with high levels of technical
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competences of our patients and families.
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Excellent care and support in these challenging times.
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And thank you for listening.
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Yeah.