Abstract Abstract Background: Polycythemia vera (PV) is a chronic myeloproliferative neoplasm, which is a threat to life. Teamwork is needed during the process of treatment and care of patients suffering from PV, which is a chronic illness. Especially, important roles fall to the nurses within the team. Objective: The purpose of this article is to assess the symptoms in connection with PV and the treatment and the difficulties which have been experienced, in accordance with the System for the Categorisation of Nursing Diagnoses of the North American Nursing Diagnosis Association (NANDA) and present possible nursing diagnoses and the management of symptoms according to these diagnoses. Methods: This review article was carried out by have been scanned with the search terms PV, care and nursing in PubMed databases, CINAHL, Ebsco Academic Search Complete, Scopus and Scholar Google databases.
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The approaches directed at the nursing diagnoses which have been determined in the article, are based on the papers from peer-reviewed publications, books, guidelines and the recommendations made by medical professionals. Results and conclusion: The important nursing diagnosis related with PV are altered gas exchange, altered tissue perfusion, fatigue, high risk of injury, high risk of infection, deterioration of comfort (itching), high risk of impaired skin integrity and pain. It was not possible to find any randomized controlled studies on this subject. It is recommended that these diagnosis and differences are taken into account in nursing interventions.
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Nurses need to use a patient centred approach in the administration of PV, in order to assess the patients, plan care and achieve the self-management of the disease with the patient, who has been empowered with knowledge. Keywords Polycythemia vera; Nursing care; Nursing diagnosis Introduction Polycythemia vera (PV) is a chronic myeloproliferative neoplasm, which is characterised with the clonal proliferation of the erythroid, myeloid and megakaryocytic series and which is a threat to life [,].
The foundation is prepared for the formation of blood clots in all of the tissues and organs, together with an increase in the viscosity and volume of blood in particular, and many systems such as the central nervous system and the cardiovascular and gastrointestinal systems are affected [,]. While PV, which increases with age, is seen in a rate of 10.9 out of every one million people in America [], it has not been possible to reach data on the incidence of the illness in Turkey. According to the diagnosis criteria of the World Health Organisation, 2 major and 1 minor or 1 major and 2 minor criterion need to be present at the same time for a diagnosis of PV. The major criteria are haemoglobin levels in men being >18.5 g/dl and >16. Campbell county kentucky drivers test. 5 g/dl in women, or the presence of the other findings of increased masses; and the positivity of other functionally similar mutations, such as the JAK2 and V61F7 or JAK2 Exon 12 mutation.
The minor criteria, on the other hand, are a bone marrow biopsy displaying hyper-cellularity based on age, lower than normal serum erythropoietin levels and the formation of in vitro endogenous erythroid colonies []. The symptoms in polycythemia patients are generally asymptomatic, while generally being headaches due to hyper-viscosity and hypervolemia, as well as nose bleeds, tinnitus, vertigo, vision disorders, dyspnoea, angina, a florid appearance and a burning sensation in the hands and feet. Additionally, symptoms of petechia, purpura, ecchymosis, splenomegaly, hepatomegaly, peptic ulcers and hyperuricaemia are seen [,]. Cardiovascular risk factors (hypertension, hypercholesterolemia, diabetes, smoking) increase the risk of complications in advanced ages in particular [,]. According to the information relayed from Barbui and Finazzi, while thrombotic incidents develop in 38.4% (n=1638) of PV patients, 41% of deaths in PV develop as a result of cardiovascular incidents, 13% as a result of PV turning into a haematological illness such as acute leukaemia and 4% as a result of major bleeding [].