The nurse provides care for a client diagnosed with polycythemia vera. Which statement by the client would require immediate follow-up?

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Polycythemia vera (PV) is a hematological disorder in which too many RBCs (and often WBCs and platelets) are produced, causing increased blood viscosity, venous stasis, and increased risk for thrombus formation. The nurse should teach clients with PV measures to prevent thrombus (eg, wearing graduated compression stockings, elevating legs when sitting, maintaining adequate hydration). Clients should also learn to monitor for and report signs and symptoms of thrombus (eg, redness, tenderness, or swelling in one leg). Reports of possible thrombus require immediate intervention to avoid serious injury (eg, stroke, pulmonary embolism) (Option B). (Option A) Venous stasis causes the skin on the face, hands, and feet to become ruddy (red). This is an expected finding. (Option C) Occasional headaches or blurred vision can result from sluggish, viscous blood flow in the brain. Aspirin therapy is used for its antiplatelet and analgesic action. The nurse should assess the client's headaches; however, they are not the priority. (Option D) Pruritis is a common occurrence in clients with PV, often after bathing. Clients should bathe with cool water and pat (not rub) themselves dry with a towel to avoid histamine release and use antihistamine creams for relief. Venous stasis can also cause itching, and aspirin can help. Educational objective: Clients with polycythemia vera are at risk for developing thrombus due to increased blood viscosity and stasis. Signs of thrombus (eg, swelling, redness, or tenderness in one leg) require immediate follow-up to avoid embolization and stroke or pulmonary embolism.

The Nurse Provides Care for a Client Diagnosed with Polycythemia