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This Concept Map, created with IHMC CmapTools, has information related to: Novak_CML, Problem: Depression from altered body image, Problem:Pain from Mucositis, Problem: Infection from Mucositis, Assessment Vitals: BP 120/71 RR 24 T 38 C O2 97% on RA Access: Double lumen CVC GI/GU: NG tube for medications Continuous TPN/Lipids diarrhea Skin: Opens sores to mouth and lips Perianal breakdown Musculoskeletal: Moves all extremities, able to ambulate Psychosocial: Patient in strict isolation, mother stays with patient, siblings and father remain at home in another state. Patient has lost all of her hair and has a cushingoid appearance from steroids. at risk for Problem:Graft-versus Host disease, Problem:Pain treat with Interventions: Narcotic administration Distraction Comfort Measures, Assessment Vitals: BP 120/71 RR 24 T 38 C O2 97% on RA Access: Double lumen CVC GI/GU: NG tube for medications Continuous TPN/Lipids diarrhea Skin: Opens sores to mouth and lips Perianal breakdown Musculoskeletal: Moves all extremities, able to ambulate Psychosocial: Patient in strict isolation, mother stays with patient, siblings and father remain at home in another state. Patient has lost all of her hair and has a cushingoid appearance from steroids. at risk for Problem: Fluid and electrolye imbalances, Assessment Vitals: BP 120/71 RR 24 T 38 C O2 97% on RA Access: Double lumen CVC GI/GU: NG tube for medications Continuous TPN/Lipids diarrhea Skin: Opens sores to mouth and lips Perianal breakdown Musculoskeletal: Moves all extremities, able to ambulate Psychosocial: Patient in strict isolation, mother stays with patient, siblings and father remain at home in another state. Patient has lost all of her hair and has a cushingoid appearance from steroids. at risk for Problem: Depression, poor oral intake because of Mucositis, Assessment Vitals: BP 120/71 RR 24 T 38 C O2 97% on RA Access: Double lumen CVC GI/GU: NG tube for medications Continuous TPN/Lipids diarrhea Skin: Opens sores to mouth and lips Perianal breakdown Musculoskeletal: Moves all extremities, able to ambulate Psychosocial: Patient in strict isolation, mother stays with patient, siblings and father remain at home in another state. Patient has lost all of her hair and has a cushingoid appearance from steroids. at risk for Problem:Pain, Problem: Fluid and electrolye imbalances perform Interventions: Daily Weights Daily Labs Accurate Intake and Output Medication administration, Interventions: Daily Weights Daily Labs Accurate Intake and Output Medication administration leads to Outcomes: Patient's pain will be at an acceptable level during transplant and pain free after discharge to home Patient will verbalize effective coping mechanisms and symptoms of depression will be decreased. Patient will have balanced fluid intake and output and electolytes Patient will be 100% engrafted and free from s/s of acute gvh within 2 months of transplant and free from s/s of chronic gvh within 6 months of transplant. Patient will be afebrile for ᡨ hours and all cultures will be negative. No signs and symptoms of infection will be present. Patient will take all medications and nutrition by mouth within 1 year of transplant. Patients weight will remain stable . Patient will tolerate feeds via NG tube within 2 weeks of transplant, Interventions: Increased immunosuppression Monoclonal antibodies Gut rest for GI GVH leads to Outcomes: Patient's pain will be at an acceptable level during transplant and pain free after discharge to home Patient will verbalize effective coping mechanisms and symptoms of depression will be decreased. Patient will have balanced fluid intake and output and electolytes Patient will be 100% engrafted and free from s/s of acute gvh within 2 months of transplant and free from s/s of chronic gvh within 6 months of transplant. Patient will be afebrile for ᡨ hours and all cultures will be negative. No signs and symptoms of infection will be present. Patient will take all medications and nutrition by mouth within 1 year of transplant. Patients weight will remain stable . Patient will tolerate feeds via NG tube within 2 weeks of transplant, Problem: Inadequate nutrition due to poor oral intake, Problem: Infection from immunosuppression, Assessment Vitals: BP 120/71 RR 24 T 38 C O2 97% on RA Access: Double lumen CVC GI/GU: NG tube for medications Continuous TPN/Lipids diarrhea Skin: Opens sores to mouth and lips Perianal breakdown Musculoskeletal: Moves all extremities, able to ambulate Psychosocial: Patient in strict isolation, mother stays with patient, siblings and father remain at home in another state. Patient has lost all of her hair and has a cushingoid appearance from steroids. at risk for Problem: Infection, Interventions: Narcotic administration Distraction Comfort Measures leads to Outcomes: Patient's pain will be at an acceptable level during transplant and pain free after discharge to home Patient will verbalize effective coping mechanisms and symptoms of depression will be decreased. Patient will have balanced fluid intake and output and electolytes Patient will be 100% engrafted and free from s/s of acute gvh within 2 months of transplant and free from s/s of chronic gvh within 6 months of transplant. Patient will be afebrile for ᡨ hours and all cultures will be negative. No signs and symptoms of infection will be present. Patient will take all medications and nutrition by mouth within 1 year of transplant. Patients weight will remain stable . Patient will tolerate feeds via NG tube within 2 weeks of transplant, Assessment Vitals: BP 120/71 RR 24 T 38 C O2 97% on RA Access: Double lumen CVC GI/GU: NG tube for medications Continuous TPN/Lipids diarrhea Skin: Opens sores to mouth and lips Perianal breakdown Musculoskeletal: Moves all extremities, able to ambulate Psychosocial: Patient in strict isolation, mother stays with patient, siblings and father remain at home in another state. Patient has lost all of her hair and has a cushingoid appearance from steroids. at risk for Problem: Inadequate nutrition, Problem:Pain from skin breakdown, Interventions: Frequent vital signs Frequent Assessments Isolation precautions Antibiotics/steroids leads to Outcomes: Patient's pain will be at an acceptable level during transplant and pain free after discharge to home Patient will verbalize effective coping mechanisms and symptoms of depression will be decreased. Patient will have balanced fluid intake and output and electolytes Patient will be 100% engrafted and free from s/s of acute gvh within 2 months of transplant and free from s/s of chronic gvh within 6 months of transplant. Patient will be afebrile for ᡨ hours and all cultures will be negative. No signs and symptoms of infection will be present. Patient will take all medications and nutrition by mouth within 1 year of transplant. Patients weight will remain stable . Patient will tolerate feeds via NG tube within 2 weeks of transplant, Problem: Depression from isolation