A client with polycythemia vera comes to the clinic for a monthly treatment. The nurse knows that treatment for this condition will consist of which of the following?

Question

A client with polycythemia vera comes to the clinic for a monthly treatment.  The nurse knows that treatment for this condition will consist of which of the following?

Quizplus · Accepted Answer

Polycythemia vera (PV) is a chronic myeloproliferative disorder in which the bone marrow produces an abnormally high number of RBCs. Although PV is an abnormality of the bone marrow, secondary polycythemia can occur in an individual with chronic hypoxemia, such as chronic obstructive pulmonary disease or chronic lung disease. The danger of PV is seen when the client develops blood clots-due to the increased viscosity of the blood, which makes the circulation sluggish-and decreased tissue perfusion. Treatment of PV usually includes periodic phlebotomy, the removal of 300-500 mL of blood through venipuncture, to reduce the RBC count and achieve a hematocrit <45%. Initially, clients may require phlebotomy every other day until the goal hematocrit is reached. Hematocrit is then monitored monthly, and additional blood draws are performed as necessary. (Option A) A blood transfusion is contraindicated in a client with PV because this would have the opposite of the desired effect, further increasing the RBC count and clotting. (Option B) Although an IV fluid bolus may be helpful in the short term to reduce blood viscosity, it is not a maintenance treatment for PV. Instead, the client should be encouraged to drink >3 L of fluid daily and avoid dehydration. (Option D) Steroid injections are not typically used to treat PV. Educational objective: A client with polycythemia vera requires periodic therapeutic phlebotomy treatments to reduce the RBC count and risk of blood clotting associated with increased blood viscosity.

A Client with Polycythemia Vera Comes to the Clinic for a Monthly